Epilepsy following middle-fossa extradural retraction: implications for driving.

New-onset epilepsy has several social and financial repercussions. Development of seizures after middle-fossa surgery is uncommon. We present two subjects who developed epilepsy following middle-fossa surgery, requiring treatment with anticonvulsants, and discuss the implications.

[Epilepsy with polymorphic seizures in hospitalized children]. / Padaczka z napadami polimorficznymi u dzieci hospitalizowanych.

OBJECTIVES: Epilepsy with polymorphic seizures is characterised by occurrence alternately two or more types of attacks. It represents a heterogenic group, taking into consideration etiology, course, management and prognosis, especially in the developmental age. THE AIM: The aim of this research was to establish a importance of epilepsy with polymorphic seizures in hospitalized with epilepsy children; the characteristics of type of epilepsy and epileptic syndrome, type of seizures, medication and results of pharmacological therapy were studied as well. MATERIALS AND METHODS: 58 children with epilepsy with polymorphic seizures were included, out of 1225 children hospitalized with epilepsy between the years 1998 and 2004. The group consisted of 30 girls and 28 boys aged 2 weeks to 15. As diagnostic tools, neuroimaging using MRI and CT were performed. Other such as EEG and videoEEG, and also 10 types of examinations were done as well. RESULTS: Children with epilepsy and polymorfic seizures represented 4.8% of the group hospitalized with epilepsy. The majority of them were infants and children in the pre-school age. The most frequent causes of this type of epilepsy were early encephalopathies, and ceroidolipofuscinosis. Among 13 types of seizures, the most common in analysed cases were myoclonic jerks and tonic-clonic seizures. The most frequently used drugs were valproate and vigabatrin, rendering seizure-free 43% of children. Only in 1/3 of children the intellectual development was normal. CONCLUSION: The high frequency and heterogenity of epilepsy with polymorphic seizures confirms the opinion that this type of epilepsy constitute a significant issue in the epileptology of the developmental age. In most of the children epilepsy was associated with intellectual impairment, while final etiology of epilepsy in half of the children was not established. Therapy of epilepsy with polymorphic seizures was complicated and seizures were fully controlled in less than one half of the children.

A missed diagnosis. A missed opportunity for community integration.

The quality of life of people with learning disability and epilepsy, in the community, can be improved by regular review and appropriate use of anti-convulsants. This paper reports two successful outcomes using a newer anti-convulsant, lamotrigine.

What people with epilepsy want from a hospital clinic.

A questionnaire was sent to 511 patients with epilepsy who were being reviewed at the clinics of two consultant neurologists. The questionnaire asked 19 questions about seizure type and how the diagnosis was given. It also asked how much information was given about the disease and advice about living with it. There were also questions about counselling and preference for hospital or community care. Over 96% returned the questionnaire. About one third said they were not told what epilepsy was, over 90% wanted more information about the disease, and about three quarters felt they had not been given enough information about the side-effects of antiepileptic drugs. Over 60% wanted to talk to someone other than a consultant about epilepsy, the most frequent person requested being a specialist nurse. Despite this, three quarters wanted to continue to attend the hospital clinic and 89% were generally satisfied with their hospital management. This survey has highlighted a number of shortcomings in the structure of our clinics. It should be possible to correct them by providing more structured information and having a nurse specialist available.

[Landau-Kleffner syndrome]. / Landau-Kleffner-Syndrom.

The Landau-Kleffner syndrome is characterized by the combination of acquired aphasia and epilepsy. Disturbances appear at an age between 2 and 7 years. The prognosis of epilepsy is favourable, but the outcome of aphasia is different. A 15-year old boy is described as one who is totally unable to communicate through speech even 11 years after onset of aphasia. Diagnostics, aetiology, pathophysiology and new therapeutic possibilities of the syndrome are discussed.

[Epilepsy and working world--summary presentation of empirical research with special reference to reality and potential for vocational rehabilitation]. / Epilepsie und Arbeitswelt--Zusammenfassende Darstellung einer empirischen Untersuchung unter besonderer Berücksichtigung von Wirklichkeit und Möglichkeit beruflicher Rehabilitation.

Using a variety of methods (standardized and open interviewing, medical talks, ongoing counselling, expert interviews), data had been raised from almost 400 persons with epilepsy (Grand mal) of working age (16-65 yrs.), permitting their life and working situation to be characterized participant observation. The project inter alia was aimed at describing the relationship of "epilepsy and working world", to determine the extent of participation in vocational rehabilitation measures as well as their course, in order to elicit criteria pertinent for introduction of goal-directed supportive action. The study findings are outlined; a model for estimating rehabilitative need is presented; needs-based groupings are characterized, and conceptual considerations concerning vocational rehabilitation of persons with epilepsy discussed.