[Effect of phenytoin and carbamazepine on evoked potentials in patients with newly diagnosed epilepsy. Part I. Visual evoked potentials]. / Wplyw fenytoiny i karbamazepiny na potencjaly wywolane u chorych z nieleczona padaczka. Czesc I. Wzrokowe potencjaly wywolane.

Pattern-reversal visual evoked potentials (VEPs) were recorded in 64 patients with newly diagnosed epilepsy. Before starting medication the patients with partial and primary generalized epilepsy, had prolonged latencies of the VEPs component P100, as compared with controls. VEPs were repeated after 3 months in 43 patients with focal epilepsy, during carbamazepine (22 cases) or phenytoin (21 cases) treatment. The plasma concentration of the drugs were within therapeutic levels. Carbamazepine but not phenytoin, was associated with prolongation of the P100 peak latency and induced increase of its amplitude, as compared with the baseline condition. The VEPs abnormality was most pronounced in patients whose seizures were poorly controlled. We conclude, that administration of carbamazepine or phenytoin, at therapeutic serum level, have minimal effect on the VEPs.

[Effect of phenytoin and carbamazepine on evoked potentials in patients with newly diagnosed epilepsy. Part II. Brainstem auditory evoked potentials]. / Wplyw fenytoiny i karbamazepiny na potencjaly wywolane u chorych z nieleczona padaczka. Czesc II. Sluchowe pniowe potencjaly wywolane.

Brainstem auditory evoked potentials (BAEPs) were studied in 64 untreated epileptics with partial (58) and primary generalized seizures (6). Patients were randomized to have either phenytoin (PHT) or carbamazepine (CBZ) monotherapy. Follow-up recordings were made 3 months after PHT (21) or CBZ (22) monotherapy in 43 patients with partial seizures. Before treatment epileptic patients and controls did not differ in BAEPs results. All patients had therapeutic PHT or CBZ levels. PHT prolonged I-III and I-V interpeak latencies (IPL), and central conduction time (I-V) changes were correlated with the patients age. CBZ increased the latency of wave I and the central conduction time. The prolongation of I-III IPL was significant only for the group with partial secondarily generalized seizures and the III-V for the group with partial seizures without generalization. These results suggest similar effects of CBZ and PHT on BAEPs within serum therapeutic range.

[Effect of hemodialysis on somatosensory evoked potentials of medium and long latency]. / Wplyw hemodializ na somatosensoryczne potencjaly wywolane o sredniej i dlugiej latencji.

In 16 patients with terminal renal failure aged from 21 to 74 years maintained on haemodialysis programmes for 2 to 60 months somatosensory evoked potentials were studied after stimulation of the median nerve immediately before and after haemodialysis. The central conduction time, the P 45-N 60, P 100-N 140-P 200 complexes and the P 300 wave were evaluated. The results were compared with those in 16 healthy volunteers aged 20 to 66 years. In the patients on haemodialyses the evoked somatosensory potentials of medium and long latency differed statistically significantly from those in the control group, but not direct effect of haemodialysis on these potentials was found.

Creutzfeldt-Jakob disease in young people.

Three neuropathologically confirmed cases of Creutzfeldt-Jakob disease in young people (19, 23, and 27 years of age) are described. None had received pituitary hormone therapy. At the onset of illness all patients were suspected of having SSPE or other viral encephalitis, because of the similarity of clinical symptomatology and the shift towards older age of SSPE onsets observed in Poland in recent years.

[Surgically treated epidural hematoma of the spinal cord at the Th1-Th2 levels associated with arachnoid cyst]. / Krwiak nadtwardówkowy rdzenia kregowego na poziomie Th1-Th2 skojarzony z torbiela pajeczynówki, leczony operacyjnie.

In a man aged 28 clinical picture, myelography and computerized myelotomography demonstrated epidural haematoma at the level of Th1-Th2 vertebrae with associated arachnoidal cyst. Owing to initially erroneous diagnosis of transverse myelitis the haematoma was diagnosed only after 7 days and removed surgically with simultaneous evacuation of the cyst. The therapeutic result was minimal.

[The Tolosa-Hunt syndrome. Case report]. / Zespól Tolosy-Hunta. Opis przypadku.

A case of headaches with recurrent paralysis of cranial nerves III, IV, V and VI is reported. A good therapeutic effect was obtained with corticoids. After ruling out other diseases and causes of ophthalmoplegia the Tolosa-Hunt syndrome was diagnosed.

[Familial occurrence of calcinosis of the basal ganglia]. / Rodzinne wystepowanie zwapnien jader podstawy mózgu.

In two sisters aged 36 and 38 years symmetrical calcifications were found in the vicinity of the pallidum in brain CT. In the younger sister epileptic seizures and transient focal signs were due to arrhythmias of the heart caused by mitral valve leaflet prolapse. In the second case no neurological signs were found. The calcifications were probably genetically determined suggesting an autosomal recessive inheritance. The described cases are another example of familial calcifications in basal ganglia without neurological changes.

[A case of cerebral cysticercosis treated with praziquantel in the postoperative period]. / Przypadek wagrzycy mózgu leczony operacyjnie praziquantelem.

A 51-year-old man with cerebellar signs and raised intracranial pressure had negative indirect and serological tests for cysticercosis. During operation cysticerci were removed from the cisterna magna, fourth ventricle and aqueduct. Histological examination confirmed the diagnosis of cysticercosis. After operation the condition of the patient deteriorated consciousness disturbances, involuntary movements of the left upper extremity and paraparesis appeared. Only after treatment with Praziquantel with simultaneous administration of oedema-reducing agents nearly complete regression of neurological manifestations was achieved.

[Familial cerebellar ataxia: clinical, radiological and electrophysiological findings]. / Rodzina z bezladem mózdzkowym. Ocena kliniczna, radiologiczna i elektrofizjologiczna.

A family with cerebellar ataxia of late onset occurring in four generations was observed. Neurological abnormalities included signs of cerebellar ataxia, pyramidal tract damage and damage to the peripheral motor neuron. Computerized tomography demonstrated in five out of six studied patients an image suggesting olivo-ponto-cerebellar atrophy. In the cerebellar structures, brainstem and cerebral hemispheres evidence of atrophy was detected. No correlation was demonstrated between the intensity of the clinical signs and the progression of changes in CT image. Electrophysiological investigations demonstrated changes compatible with damage to the motor and sensory fibres in the peripheral nerves and signs suggesting damage to the spinal motor neurons and pyramidal tract. These observations confirm the multilevel development of the process. The use of similar diagnostic methods will permit a more accurate classification of cerebellar ataxia and obtaining of better information for prognostication of individual cases.

[Neurologic symptoms in lithium poisoning]. / Objawy neurologiczne w przebiegu zatrucia litem.

A 69-year-old female patient is reported who had been treated with lithium salts for bipolar affective disease. During hospital stay due to myocardial infarction in cardiology department signs of intoxication with lithium carbonate developed. Parkinsonian syndrome and amnesia with abnormal EEG tracings were observed. After withdrawal of lithium and correction of water and electrolyte disturbances as well as pharmacological treatment gradual disappearance of neurological abnormalities was observed, with full normalization of EEG tracings.

Cerebellar atrophy diagnosed by computed tomography and clinical data.

The diagnostic relevance of computed tomography (CT) in the classification of cerebellar atrophy or degeneration is unclear. Twenty-one patients with cerebellar atrophy at CT were studied and the findings were correlated to clinical data. Based upon such data the material was divided into two groups. In the first group (12 patients), with signs of cerebellar deficiency, 6 cases presented familial hereditary ataxia, and olivopontocerebellar atrophy of the Menzl type, 3 ataxia telangiectasia (Louis-Bar syndrome), 2 olivopontocerebellar atrophy of the sporadic type, and 1 adrenoleukodystrophy. In the second group (9 patients), without cerebellar deficit, cerebellar atrophy was found only occasionally. In all of them, there was cerebral atrophy. Clinically manifest cerebellar deficiency and cerebellar atrophy as evident at CT was mainly found in patients with familial genetic disorders. Cerebellar and/or vermian atrophy without clinical signs of cerebellar deficiency were observed only occasionally and were not specific.

[A case of acute necrotizing encephalitis caused by herpes simplex virus--a clinico-morphological analysis]. / Przypadek ostrego nekrotyzujacego zapalenia mozgu wywolanego wirusem opryszczki--analiza kliniczno-morfologiczna.

The authors report a detailed clinico-morphological analysis of a case of acute necrotizing encephalitis caused by herpes virus. The diagnosis was based on a high titre of antibodies against the antigen of Herpes virus and on changes in computer tomograms. It was confirmed by gross and microscopic examinations of the brain.

[Fisher's syndrome]. / Zespól Fishera.

The authors describe a 43-year-old man with ophthalmoplegia, ataxia and areflexia and with 0.42 g/l of protein in the cerebrospinal fluid. EMG disclosed some slowing down of the conduction velocity in the motor fibres of the extremities. Treatment with synacthen depot, cocarboxylase and vitamins gave a good effect. The described case corresponds closely to Fisher's syndrome and may be a special form of brain-stem encephalitis involving the mesencephalon.

[Comparative evaluation of seizure provocation methods with sleep deprivation and Brietal in epileptics]. / Porównawcza ocena metod prowokacji pozbawieniem snu i Brietalem w padaczce

In 10 patients with suspected epilepsy in whom routine EEG investigations failed to demonstrate changes the sleep deprivation method and intravenous injection of 1% Brietal solution were used as provocation methods. The efficiency of both methods was compared. In cases in which sleep deprivation provoked appearance of pathological changes Brietal gave a similar result but evoked more frequently the manifestation of focal changes. In cases in which sleep deprivation was ineffective Brietal provoked slight changes in some cases only. Both methods may be used for provocation and Brietal may be more suitable in cases with suspected focal lesions.