[Correlations between E.E.G. findings and intracranial pressure (ICP) during treatment of acute post-traumatic intracranial hypertension (preliminary report) (author's transl)]. / Corrélations E.E.g. - pression intra-cranienne au cours du traitement de l'hypergension intra-cranienne traumatoque aiguë par alfathésine (Note préliminaire).

An infusion of a 10% solution of Althesin was administered for treatment of acute post-traumatic intracranial hypertension. Six comatose patients, aged from 7 to 22 years, without neurosurgical lesions, were treated with doses of the compound varying from 40 to 400 ml per day for 1 to 6 days. Daily polygrahic recordings (E.E.G, E.M.G., E.K.G., respiration and I.C.P.) were made in all patients for periods of 4 to 8 hours. Doses lower than 0.12 ml/min. caused a slight reduction in I.C.P. in two patients, without variations in the E.E.G. Doses between 0.12 and 0.36 ml/min. provoked a reduction in I.C.P. in all patients, and the appearance of burst suppression in the E.E.G. in those patients with an "alternating" tracing only. Higher doses (0.36 to 0.72 ml/min.) caused a reduction in I.C.P. less than 50% in 5 of the 6 patients. Continuous slow wave tracings and border-line tracings showed less constant modifications. The reactivity of the I.C.P. and the E.E.G. to Althesin appears earlier and is more evident in patients with an alternating E.E.G. tracing and with pressure waves of the Lundberg type b. No side effects related to the use of barbiturates were noted after interrupting treatment.

[Althesin in the treatment of status epilepticus]. / L'althesin nel trattamento dello stato di male epilettico.

In view of its anticonvulsant effects in the experimental animal, its low toxicity, and its manageability, Althesin was used at doses of 80-600 mg in the treatment of barbiturate and benzodiazepine resistant epilepsy in 11 patients aged 15 months to 62 yr. Lasting suspension of the disease was obtained in 8 subjects. Burst suppression was achieved in 7 of these cases with 80-120 drops/min of a 10% solution of Althesin in 10% laevulose. No side-effects were observed.

[Thrombosis of the right internal jugular vein caused by a catheter in the subclavian vein. A complication precluding the insertion of a ventriculo-atrial cerebrospinal fluid shunt]. / Trombosi della vena giugulare interna destra da catetere in succlavia. Una complicanza che ha precluso l'inserzione di derivazione liquorale ventricolo-atriale.

The Authors describe a case of right internal jugular vein thrombosis caused by a catheter in the subclavian vein which occurred in a four-month-old baby with chronic subdural hematomas. They emphasize that this thrombotic complication precludes the insertion of a ventriculo-cardiac shunt and point out the opportunity to prefer left subclavian cannulation in those patients who probably will need a ventriculo-cardiac shunt.

The use of althesin in drug-resistent status epilepticus.

The properties of Althesin (anticonvulsant activity, depression of oxygen consumption, lowering of ICP, rapid excretion) led us to use this steroid combination to treat 11 patients in status epilepticus resistant to the standard drugs (benzodiazepines and barbiturates). The administration of Althesin by slow intravenous injection was ineffective in 2 of the 3 patients thus treated. The doses used (2--10 ml) were probably too small. One only administration of a 10% solution of Althesin in 10% fructose by intravenous drip (the rate was calculated so as to obtain the burst suppression stage at the EEG) stopped status epilepticus in 7 of the 9 patients thus treated. In this group the doses used varied from 25 to 50 ml. The 2 patients in whom it was necessary to repeat Althesin administration and combine it with other drugs had both been operated on for severe brain injuries involving marked cerebral edema. In spite of the very small number of cases, the definitive arrest of status epilepticus obtained in 8 out of 11 patients first treated with other drugs is encouraging: Althesin probably may be regarded as an adjunct in the treatment of status epilepticus.

[Activation with amitriptyline: electroclinical comments on 120 epileptic patients (author transl's)]. / Activation par l'amitriptyline (Remarques électrocliniques à propos de 120 patients épileptiques).

The sleep-inducing and epileptogenic effects of amitripyline (0.5 mg/kg i.m.) were studied in 120 epileptic patients. Sleep occurred in 94 p. 100 of the patients: 92 p. 100 showed stages I and II, 42 p. 100 also showed stages III and IV, but only 12 p. 100 showed REM. Major activation of inter-ictal abnormalities occurred in 41 p. 100 and seizures were provoked in 17 patients (14 p. 100). Neutral results were obtained in 23 p. 100 of cases. The results obtained and the complete absence of drawbacks recommend amitriptyline for use in studying epileptic patients, at least before turning to other pharmacological techniques which are more dangerous and probably less reliable.