Prevalence of epilepsy in Croatia: a population-based survey.

OBJECTIVES: To investigate the prevalence of active epilepsy in Croatia. MATERIAL AND METHODS: Patient data collected by means of questionnaires completed by primary healthcare physicians; epilepsy was previously confirmed in the patients by neurologists or neuropaediatricans. RESULTS: One hundred and twenty-seven of 180 (71%) physicians provided the requested information. The total sample was 212 069 people and of these 1022 had active epilepsy. Prevalence rates (per 1000) for the following age-groups were: age 0-7: 3.5; age 8-18: 6.4; age 19-45: 5.0; age 46-65: 4.7; age >65: 4.4. The age-adjusted prevalence rates for the standard populations were 4.9/1000 (European population) and 5.0/1000 (WHO world population). Fifty-one physicians (29%) stated only the number of patients they considered as having active epilepsy but without the requested details. If their patients were also included, the estimated crude prevalence rate would be 5.5/1000. CONCLUSIONS: It is likely that the prevalence of active epilepsy in Croatia is between 4.8 and 5.5/1000; this is in keeping with findings from other European countries.

Detection of IgG oligoclonal bands in unconcentrated CSF by isoelectric focusing in ultrathin polyacrylamide gel, direct antiserum immunofixation and silver nitrate staining.

Isoelectric focusing of proteins in ultrathin polyacrylamide gel (0.4 mm), followed by direct immunofixation with monospecific antisera and silver nitrate staining, is a highly specific, sensitive and simple method for the detection of oligoclonal IgG in unconcentrated CSF samples. The ultrathin polyacrylamide gels have several advantages, i.e. significantly smaller amounts of reagents are required, and thinner gel can be more efficiently cooled, resulting in higher resolution and shorter running, washing, staining and destaining times. Direct immunofixation in the gel, a time-saving and simple step, increases the sensitivity and specificity of the method. We reduced the samples to 5-10 microliters. For the present method, the optimal concentration of IgG was 0.025-0.030 g/l. It is possible to detect oligoclonal IgG bands at an IgG concentration corresponding to the applied amount of 80-100 ng. In our testing of this method, oligoclonal bands in CSF specimens were clearly demonstrated in 33 (97%) out of 34 patients with definite multiple sclerosis, in 16 (42%) out of 38 patients with infectious diseases of the central nervous system and in 11 (18%) out of 58 patients with other neurological disorders. The method appears to be a useful alternative for the demonstration of oligoclonal IgG bands in unconcentrated CSF samples, and can be recommended for use in the CSF laboratory routine.

Detection of oligoclonal IgG bands in unconcentrated CSF in multiple sclerosis and other neurological diseases by isoelectric focusing on ultrathin-layer polyacrylamide gel immunofixation and silver staining.

Isoelectric focusing of proteins (IEF) in ultrathin-layer polyacrylamide gel (0.4 mm, PAG), followed by direct immunofixation with monospecific antiserum and silver staining, is a highly specific, sensitive and simple method for the demonstration of oligoclonal IgG in unconcentrated cerebrospinal fluid (CSF) samples (5-10 microliters). For the present method, the optimal concentrations of IgG in CSF samples are about 0.025-0.030 g/l, corresponding to the applied amount of 125-150 mg. In our testing of this method, oligoclonal IgG bands in CSF specimens were clearly demonstrated in 52 (96%) of 54 patients with clinically established definite diagnosis of multiple sclerosis (MS), in 4 (40%) of 10 patients with infectious diseases of the CNS, and in 9 patients (25%) of 38 with other neurological diseases. Abnormal patterns were also demonstrated in the serum of patients with MS (43%). Intrathecally synthesized IgG was mathematically calculated in 43 (80%) out of 54 patients with MS. This method appears to be a useful alternative for the demonstration of oligoclonal IgG bands in the unconcentrated CSF, especially when questionable or negative results arise by routine electrophoretic technique for oligoclonal bands detection.