Der Nervenarzt
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A patient with focal epilepsy that was resistant to medical treatment received add-on therapy with vigabatrin. Six months after commencement of vigabatrin therapy, allergic vasculitis caused by vigabatrin was diagnosed. ⋯ The diagnosis was based on the lymphocyte transformation test and the clinical course. The allergic vasculitis was healed by cortisone therapy.
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Biography Historical Article
[The psychiatric disease of Vincent van Gogh].
From more than 650 letters of van Gogh psychopathologically striking phrases were collected. Their occurrence in the last 18 years of van Gogh's life was observed. The very different interpretations of his symptoms were compiled in a schedule. Finally the case of van Gogh's is used to discuss the borderline between psychosis and epilepsy, a topic which has long been neglected in German psychiatric teaching.
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Epilepsy is the most common neurological disease of females in reproductive age. Problems concerning contraception, reproduction, teratogenicity and antiepileptic therapy preceding and during pregnancy are discussed and recommendations made. We underline the advantages of a planned pregnancy with optimal adjustment of antiepileptic drug therapy and recommend prophylactic treatment with folic acid before and during, and with vitamin K towards the end of pregnancy.
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The therapeutic concept of local administration of opioids into the perimedullar and cerebrospinal fluid is the result of fundamental studies concerning the discovery and localization of specific binding sites. These studies provoked considerable clinical interest, because they suggested a non-destructive and fully reversible method. In our department we have been gathering experience with an implantable pump system for various indications of chronic pain on a sample of 25 patients. ⋯ Nine of the patients with cancer-related pain experienced from excellent to acceptable pain relief, as did also 10 patients with chronic non-malignant pain. Side effects were rare. Our findings also indicate that, in carefully selected patients, both malignant and non-malignant pain may be managed satisfactorily with this technique.