Juvenile myoclonic epilepsy: clinical characteristics, treatment and prognosis in a Norwegian population of patients.

Forty-three patients with juvenile myoclonic epilepsy (JME) is presented. The female to male ratio was 2.9:1. The patients answered a standardized questionnaire pertaining to social situation, medical history, onset of epilepsy, types and frequency of seizures, treatment, experienced control over seizures and consequences of having epilepsy. Myoclonic jerks, which are the hallmark of the condition, are often forgotten by the patients or not considered as epileptic seizures. This could be one reason why JME still seems underdiagnosed. JME may comprise absence, myoclonic and generalized tonic-clonic seizures (GTCS), proposed to occur in age-related sequence. We found that absence seizures may start after onset of other seizures. Our results confirm the need for medication since, during the last year, only 7% were seizure free without medication. Of patients on antiepileptic drugs (AEDs), 79.5% had no GTCS and 41% were seizure free during the last year, which confirms a relatively good response to appropriate treatment. Although most patients used AED daily and many still had one or more types of epileptic seizure, the epilepsy in general had very little impact on their lives.

IgA and rheumatoid factor in ankylosing spondylitis.

The elevated serum IgA in seronegative arthritis and psoriasis is not well understood. We examined 112 patients with ankylosing spondylitis for IgA RF, IgG RF and IgM RF by an ELISA method. Two, two and ten patients were RF positive in each Ig class, respectively. Presence of RF was not correlated with Ig concentrations, with presence of HLA-B27, nor with clinical disease signs. It was concluded that RF may be seen in ankylosing spondylitis, but the increased IgA concentrations in such patients are not IgA RF.

Quantitation of rheumatoid factors (RF) of IgM, IgA and IgG isotypes by a simple and sensitive ELISA. Discrimination between false and true IgG-RF.

An enzyme-linked immuno-sorbent assay (ELISA) for quantitation of rheumatoid factors (RF) of IgM, IgA and IgG isotypes has been established. A complex of human serum albumin (HSA) and rabbit IgG anti-HSA antibodies is used as antigen for RF. The binding of RF is detected by stepwise additions of biotinylated monoclonal antibodies specific for human IgM, IgG or IgA, alkaline phosphatase-conjugated streptavidin, and substrate. The assay is simple and applicable to routine testing of large numbers of sera. It discriminates between false and true IgG-RF by papain digestion of sera that turn out positive by the screening for IgG-RF. Of 241 randomly selected patients with rheumatoid arthritis (RA) as well as other rheumatoid and infectious diseases, 110 were Waaler-Rose-positive while 127 were IgM-RF-positive in ELISA. The correlation between the Waaler-Rose test and IgM-RF ELISA was highly significant (r = 0.82). By testing 65 of these sera (all IgM-RF positive), 25 (39%) were also true IgG-RF positive (42 (64%) in the screening). When 40 Waaler-Rose-positive RA patients were tested, 20 and 21 were also positive for IgG- and IgA-RF, respectively. Eight IgM-, one IgA- and no IgG-RF positive tests were recovered when 48 Waaler-Rose negative RA patients were studied.