The occurrence and characteristics of auras in a large epilepsy cohort.

OBJECTIVES: Despite several studies, estimates of the frequency with which auras occur in conjunction with epilepsy continue to be imprecise. The aim of this study was to assess the occurrence and characteristics of auras in a large population-based epilepsy cohort. MATERIALS AND METHODS: Subjects with verified epilepsy were recruited from population-based twin registries in the USA, Denmark and Norway. Using a structured interview in which a list of auras was provided, subjects were asked about the warning symptoms preceding their epileptic attacks. RESULTS: 31% of the total sample (n = 1897) and 39% of those with active epilepsy (n = 765) had experienced an aura. Six percent reported more than one type. Non-specified auras were most frequently reported (35%), followed by somatosensory (11%) and vertiginous (11%). While the majority of those reporting auras (59%) had focal epilepsies, auras of a mostly non-specific nature were experienced by 13% of those with generalized epilepsies. CONCLUSION: Auras serve an important purpose in that they may prevent seizure-related injuries and could provide an indication as to where the seizures originate. The occurrence of auras often is underestimated, especially in children and those with learning disabilities.

Genetic screening of Scandinavian families with febrile seizures and epilepsy or GEFS+.

BACKGROUND: Mutations in the three genes SCN1A, SCN1B and GABRG2, all encoding subunits of ion channels, have been known to cause generalized epilepsy with febrile seizures plus (GEFS+) in families of different origin. OBJECTIVE: To study the occurrence of mutations in these genes in families with GEFS+ or a GEFS+ resembling phenotype of Scandinavian origin. MATERIAL AND METHODS: We performed linkage analysis in 19 Scandinavian families with a history of febrile seizures (FS) and epilepsy or GEFS+. Where linkage could not be excluded, the genes of interest were sequenced. RESULTS: We identified only one mutation in SCN1A, which seems to be a rare variant with no functional consequence. CONCLUSION: This suggests that mutations in these three genes are not a prevalent cause of familial cases of FS and epilepsy or GEFS+ in Scandinavia.

[Genetic disease in general practice. An interview study among general practitioners in Oppland and Oslo]. / Genetisk sykdom i allmennpraksis. En intervjuundersøkelse blant allmennpraktikere i Oppland og Oslo.

We interviewed 51 Norwegian general practitioners selected at random about their knowledge and practice of medical genetics. Of these doctors, 29 worked in Oslo and 22 in Oppland county. About 90% of the doctors working in Oslo knew where to refer patients for genetic counselling, while 55% of the doctors working in the area outside Oslo had this knowledge. We believe that this difference is because Oslo has a municipal genetic clinic and is the only area in Norway with an adequate genetic counselling service according to WHO standards. This article presents the results from this survey, and discusses genetic diseases in general practice and the organisation of medical genetic services in Norway.

The epidemiology of pregnancy complications and outcome in a Norwegian twin population.

OBJECTIVE: To measure the contribution of genetic factors to selected pregnancy complications, including miscarriage, twinning, hypertension-toxemia, and nausea-vomiting. METHODS: Information on 22,241 pregnancies of 8675 female twins or spouses of male twins was obtained by questionnaire from members of the population-based Norwegian Twin Panel. Comparisons of observed tetrachoric correlations were used to assess the importance of genetic influences on the variables examined. RESULTS: Pregnancy history information was provided by both members of 830 monozygotic and 902 dizygotic female twin pairs and by the spouses of both members of 459 monozygotic and 464 dizygotic male twin pairs. The incidence of twin pregnancy in general, and of opposite-sexed twins in particular, found among dizygotic twin women was nearly twice that observed for any other group. Monozygotic female twin pairs were more concordant than dizygotic female twin pairs for the occurrence of miscarriage, nausea or vomiting during pregnancy, and hypertension or overt toxemia. A similar pattern of twin similarity was observed for the use of certain medications during pregnancy including vitamins, aspirin, and nausea medication. CONCLUSIONS: Maternal genetic factors make an important contribution to a predisposition for dizygotic twinning, contribute to the risk of miscarriage, and appear to determine, in part, whether a woman experiences nausea-vomiting or hypertension-toxemia during pregnancy. In addition, health-seeking behaviors of women during pregnancy, as reflected by the use of several classes of medication, appear to be influenced somewhat by genetic factors.

The occurrence of epilepsy and febrile seizures in Virginian and Norwegian twins.

Twin studies provide an efficient method for examining the importance of genetic and environmental factors in the etiology of disorders such as epilepsy. Population-based twin registries are especially valuable for studies of this type since effects of reporting and self-selection biases on the resulting data are minimized. Among 14,352 twin pairs contained in the Virginia and Norwegian twin panels for whom questionnaire information was available, there was a history of epilepsy in one or both members of 286 pairs; febrile seizures were reported in 257 pairs. Analyses of questionnaire data revealed no significant differences in concordance rates between Virginian and Norwegian twins for either epilepsy or febrile seizures. Probandwise concordance rates for epilepsy were 0.19 in monozygotic twins and 0.07 in dizygotic twins. Analogous rates for febrile seizures were 0.33 (monozygotic) and 0.11 (dizygotic). These results provide further evidence that genetic factors do have a role in the expression of epilepsy and febrile seizures.

Pedigree analysis of Eysenck Personality Questionnaire (EPQ) scores in monozygotic (MZ) twin families.

MZ twins with spouses and children, altogether 811 subjects, completed the Eysenck Personality Questionnaire (EPQ). For extraversion (E), neuroticism (N), and lying (L), models including only additive genetic effects fitted well to the observed sex-specific correlations for the various sets of relationships. There was no evidence of sex differences for any parameter estimate for E, N, and L. The fit for E improved significantly after including dominance, and the fit for L improved significantly after including assortative mating. A model specifying genetic additive and dominance effects and assortative mating fitted well to the Psychoticism (P) data, but the fit improved significantly when a parameter for cultural transmission from fathers to daughters were included. Except for this, there was no evidence of cultural transmission for any scores. The heritabilities for the best-fitting models were .53 (E), .36 (N), .43 (L), and .39 (P). The latter includes almost only nonadditive, and no additive, variance, suggesting an overestimation of this effect due to random fluctuation or environmental sibling effect misinterpreted as dominance.

Effect of haptoglobin subtypes on serum lipid levels.

Haptoglobin (Hp) subtypes were analysed by two-dimensional high-resolution gel electrophoresis in 81 Norwegian individuals with moderate hypercholesterolemia and in 316 Norwegian control subjects. The frequencies of the genes Hp2SS and Hp2SF were higher in individuals with hypercholesterolemia than in controls but the differences did not reach statistical significance (p = 0.087). Within the control population, no effect of the different Hp subtypes was found on total serum cholesterol, triglycerides or high-density lipoprotein (HDL) cholesterol. However, in the controls a significantly higher frequency of Hp2-2 types was found among those with HDL cholesterol values in the upper quartile as compared to those with HDL cholesterol in the lower quartile. A similar phenomenon was not uncovered in analyses of total serum cholesterol or triglycerides. Our results are in agreement with others which indicate that genes belonging to the Hp polymorphism play a role in predicting an individual's total serum cholesterol level. However, our data indicate that the cholesterol effect is on the HDL rather than on the total cholesterol level.

Education policy and the heritability of educational attainment.

Many workers assume that genetically determined differences in intellectual ability will be influenced little by changes in educational policy or other environmental interventions. Others, however, have suggested that increasing equality of educational opportunity will lead to an increase in the heritability of educational attainment. The resolution of this issue has been delayed until now because of the extremely large sample sizes which would be required. Education data on twins and their parents, from the Norwegian twin panel, provide a unique opportunity to determine the impact on the heritability of educational attainment of the more liberal social and educational policies introduced in Norway after the Second World War. As reported here, for individuals born before 1940 there is a strong effect of family background on educational attainment, accounting for 47% of the variance, though genetic factors account for an additional 41% of the variance. For females born after 1940 and before 1961, the relative importance of genetic (38-45%) and familial environmental (41-50%) differences changes very little. For males born during the same period, the broad heritability of educational attainment has increased substantially (67-74%), and the environmental impact of family background has correspondingly decreased (8-10%). For males, at least, having well-educated parents no longer predicts educational success, as measured by duration of education, independent of the individual's own innate abilities.

Discrimination of Antibodies to Hepatitis B surface antigen from antibodies to inherited serum protein variants in immune sera of human and animal origin.

Antisera to hepatitis B surface (HBs) antigen, both of human and rabbit origin, have been examined. The anti-HBs serum derived from a multiply transfused patient did, in addition, contain antibodies directed against the inherited beta-lipoprotein antigen Ag(x), whereas one of the rabbit immune sera also contained antibody to the inherited Lp(a) antigen. Thus, in human, as well as in animal anti-HBs sera, antibodies to inherited normal serum antigens may cause false positive reactions. This problem may be overcome by absorption procedures if appropriate control systems are available. False positive reactions caused by the Ag(x) antigen may also be avoided by use of agarose as supporting medium for the test, as Ag(x) precipitin lines do not appear in this medium. An undialysable high molecular weight component may be obtained from Oxoid "Ionagar" by washing. When this is added to agarose the Ag(x) antigen reaction appears also in this medium.

Comparison of small hepatitis B surface antigen particles and human serum low density lipoprotein molecules by electron microscopy.

The small spherical particles associated with hepatitis B surface antigen (HBsAg) could be distinguished from the low density lipoprotein (LDL) molecules in human serum by examination of coded, negatively stained preparations. The HBsAg associated particles showed a more marked contrast against the background than LDL. Addition of specific antiserum to LDL caused a significantly reduced mean diameter of LDL molecules. An insignificant reduction in size of HBsAg particles was found by corresponding treatment. It is suggested that the antibody molecules protect LDL molecules protect LDL molecules against artificial flattening during preparation.