Acta neurologica Scandinavica
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Seizure-inducing effects can be observed in the treatment of epileptic patients with antiepileptic drugs (AED). This may be a paradoxical reaction (for example the increase of complex focal seizures due to carbamazepine, vigabatrin or phenytoin treatment) or a result of AED-induced encephalopathy (commonly induced by valproate in patients with complex focal seizures). A seizure increase during intoxication with AED is a rare phenomenon, thus, it is not directly related to this condition. ⋯ A seizure increase during vigabatrin therapy has been attributed to the increase of the cerebral amount of gamma-amino butyric acid, which is known to possibly exhibit inhibitory or excitatory neuronal effects. The occurrence of tonic seizures in patients with Lennox-Gastaut syndrome has been attributed to the sedative effect of the drugs; however, this conclusion is controversial. From a clinical point of view, one should consider young age of the patient, mental retardation, antiepileptic polytherapy, high frequency of seizures or prominent epileptic activity in the electroencephalogram previous to medication as risk factors for a possible seizure-inducing effect of antiepileptic drugs.
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Acta Neurol. Scand. · May 1996
Case ReportsLeft ventricular failure and pulmonary edema in acute multiple sclerosis.
We describe a young woman who developed left ventricular failure and pulmonary edema during fulminant onset of multiple sclerosis. One of the numerous plaques was located in the left inferior cerebellar peduncle near the dorsal motor vagal and solitary tract nuclei. Within two days pulmonary edema had cleared, and within three days left ventricular function was normal. To our knowledge, left ventricular failure has not earlier been verified in acute multiple sclerosis.
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Significant hospital resources are invested in early detection of intracranial complications after minor head injuries (MHI). This study focuses on economic aspects of MHI management. 88 MHI patients underwent routine early CT-scan and at least 24 h in-hospital observation. The cost of this management was calculated, and compared to estimated costs of three alternative management protocols. ⋯ The expense of our management was Norwegian Kroner (NOK) 576,136. An alternative management protocol including routing early CT-scan and discharge of patients with normal CT-findings, Glasgow coma score > or = 14 and no neurological deficits, was found to be safe, and estimated to reduce costs with 43% to NOK 326,669. It is concluded that routine early CT-scan is the most reliable and cost saving management procedure after MHI.
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Acta Neurol. Scand. · Aug 1995
Comparative StudyCSF and plasma concentrations of free norepinephrine, dopamine, 3,4-dihydroxyphenylacetic acid (DOPAC), 3,4-dihydroxyphenylalanine (DOPA), and epinephrine in Parkinson's disease.
To investigate endogenous cerebrospinal fluid catecholamines in Parkinson's disease. ⋯ These results point towards a diffuse neuronal dysfunction in Parkinson's disease and indicate that lumbar csf NE and csf DOPAC are of central nervous origin.
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Acta Neurol. Scand. · Jul 1995
Interictal and ictal dipole modelling in patients with refractory partial epilepsy.
Fifteen patients (7 men, 8 women) with mean age of 34 years and mean duration of refractory partial seizures of 17 years were included in a presurgical evaluation protocol. Neuroimaging (CAT, 1.5 T MR) demonstrated intracranial structural lesions (space-occupying: n = 9; atrophic: n = 6) and video-EEG monitoring showed complex partial seizures in all patients. Four patients underwent additional intracranial EEG monitoring that demonstrated hippocampal seizure onset in all. ⋯ Ictal dipole modelling revealed concordant results with interictal data. It shows promising but needs further confirmation and validation in a larger patient population with intracranial EEG recordings. Despite intrinsic limitations, spike voltage topography and dipole mapping contributes to a better localisation of the underlying brain source of epileptic discharges.