[Prognostic value of the EEG prior to the start and the discontinuation of anticonvulsive therapy]. / Prognostischer Wert des EEG vor Beginn bzw. Ende der antikonvulsiven Therapie.

Opinions are divided about the prognostic value of the EEG in the course of epilepsy. We thus prospectively examined 275 children with epilepsy; in particular, we analyzed the prognostic role of the EEG. Out of these 275 children 209 (76%) have been free from attacks for more than one year. In 107 children the anticonvulsive therapy was discontinued, leading to a relapse rate of 27%. According to our results, only the focal EEG changes, up to interruption of the anticonvulsive therapy, show a statistical significance in the course of epilepsy. On the other hand, a normal EEG before or normalization of the EEG after commencement of therapy and also the absence of any epileptic activity (focal or generalized), are likely to be favourable. However, we could not find a statistically significant difference.

Partial complex epileptic seizures with ictal urogenital manifestation in a child.

Ictal sexual manifestations, like somatosensory genital phenomena, sexual emotions or sexual automatisms during a partial complex seizure, are very rare. So far the literature has above all described cases in adulthood. We report on a 6-year-old boy with partial complex epileptic seizures which led to confusion, oral and genital automatisms and the urge to urinate. During one epileptic seizure with these urogenital manifestations the EEG showed an epileptic rhythmic discharge over the left temporal region.

[Simulated epileptiform discharges during the replay of a lengthy EEG recording]. / Vorgetäuschte epileptische Anfallsentladungen bei Wiedergabe einer Langzeit-EEG-Aufzeichnung.

Reviewing a longterm-EEG magnet-recording on the video system of the play-back unit "Mobile Oxford Medilog 9000" EEG patterns appeared, which imposed as epileptiform discharges. They seemed to correlate with the paroxysmal clinical disturbances the patient had experienced and noted in a diary, and could be printed out on a normal EEG-apparatus. Following investigations demonstrated the artificial origin of this EEG patterns: They appeared in fact only using the switches of the play-back unit for the fast back- and forward winding. The time-correlation between clinical and electroencephalographic episodes was simulated by the search of selected EEG-sequences based on the clinical episodes noted from the patient.

[Psychomotor seizures in infants and young children]. / Psychomotorische Anfälle bei Säuglingen und Kleinkindern.

off authors analyzed the ictal clinical symptoms (in 6 cases with videotape monitoring) of 12 infants and young children, who had focal epileptic discharges in the temporal regions (fig. 3, 4, 5). The average age was 1 9/12 years with a range of 3 months to 5 years. In 6 cases the seizures were typical "psychomotor" with oral automatisms, aimless movements of the upper extremities and/or tonic versive motor manifestations (fig. 2). In 5 cases the seizures consisted of staring and arrest of any movement. In another case, automatisms of the upper extremities were accompanied by a psychomotor arrest reaction. It is probable that in this age group seizures with sudden arrest of activity ("temporal pseudoabsences") are more frequently the main expression of partial complex seizures than in older children and in adults.

[Double-blind study on the anti-convulsive effect of phenobarbital and valproate in the Lennox syndrome]. / Doppeltblind-Untersuchung über die antikonvulsive Wirkung von Phenobarbital und Valproat beim Lennox-Syndrom.

In a double-blind crossover trial valproate was compared with phenobarbital with regard to anticonvulsive activity and tolerance in 17 epileptic children (mean age 55 +/- 26 months) with Lennox syndrome. Valproate in association with a phenobarbital dose reduced by about 40% proved to be to a statistically significant degree more active against epileptic seizures than phenobarbital alone. No difference in the effect on the EEG tracings was observed. Valproate appeared to be somewhat more active than phenobarbital with regard to behaviour, but the difference was not significant. Tolerance to both products was equally good.

[The normal neonatal EEG (author's transl)]. / Das normale Neugeborenen-EEG

Polygraphic examinations (EEG, EKG, electrooculogram and recording of respiration) were carried out on 120 full term healthy newborns. EEG recordings taken in wakefulness states showed a low-voltage background activity with a noticeable share of 8 c/sec. waves. The latter occurred in 12.5% of the examined newborn infants in more regular groups, lasting from 3--6 seconds, and reached an amplitude of up to 20--25 muV. The EEG sleep recordings differed from case to case. Certain identical EEG-patterns could be observed during active as well as during quiet sleep. Typical "tracés alternants" occurred in 63.4% of the recordings, as a rule in the quiet sleep phase. In nearly 1/3 of these cases they contained isolated fine spikes or sharp waves of variable localisation. In 70% of the sleep recordings bilateral fronto-central paroxysmal steeper transients and in 6.7% spindly about 14 c/sec. wave groups were observed, mainly during active sleep phases. In nearly 20% of the 52 newborns where the centro-temporal electrodes were connected transversally, single sharp and slow waves were recorded. They were localized resp. more pronounced in the right hemisphere. They did not appear in any of the 68 cases in which the electrodes were connected longitudinally only.

Pyritinol hydrochloride and cognitive functions: influence on children in slow learner classes.

Pyritinol-HCl was tested for its impact on the cognitive functions of children with learning disabilities. This study is a contribution to scientific discussion on the complicated methodologic problems in evaluating the clinical efficacy of psychopharmacologic agents. Sixty-seven pupils of slow learner classes between the ages of 11 and 16 years were treated for 6 months with 300 mg pyritinol-HCl/24 hr or placebo under strict double-blind conditions. Drug intake was stimulated and controlled by means of intense psychosocial interaction with the mothers of the subjects. The dependence variables used to test medication effects were 22 parameters of cognitive performance measured in psychologic tests for perceptual and intellectual functions which were administered immediately before and after the medication phase. First the gainscores before and after treatment with pyritinol or placebo within the 22 cognitive parameters were statistically compared. In addition, an analysis of covariance on the corrected results of the second test (treating the results of first testing as covariates) and a two group discriminant analysis for overall differences were performed. None of the 22 parameters showed statistically significant treatment effects with respect to average performance (t (pyritinol - placebo) = 1.96 to 1.31), neither could the two groups be separated by discriminant analysis (Hotelling's T2 = 35.4, df - 22 and 43, P = 0.465). With respect to a variability of gainscores, however, in four parameters there was a significantly higher variance in the pyritinol group (F = 1.85-2.33, P less than 0.05, less than 0.02, respectively). This fact may signify that pyritinol-HCl had different effects on different subjects. By means of prognostic stratification we therefore attempted to define objective criteria for a selection of subjects with probable positive treatment effects. None of the 15 tested criteria, such as body weight, age, perceptual handicaps, or reduced short term memory, IQ range, proved, however, to be critical for a prognosis of pyritinol effects within the present test population.