[Renin-secreting tumor detected by MRI].

We report an uncommon case of small renin secreting tumor of the kidney located in the medulla. The tumor was primarily detected by MRI and subsequently studied by spiral CT. The results and limitations of both techniques are discussed.

[Electroencephalographic findings in dementia diseases].

Even if generally the EEG cannot yield specific pointers that are typical for a special pattern of dementia, it is nevertheless meaningful and helpful to perform routine EEG in demented patients. EEG is the functional additional examination that does not place any stress on the patient and is easy to perform at a low cost (1). As a functional diagram the EEG reflects the electrical processes taking place in the cerebral cortex, yielding an excellent image of the cerebral functional state.

[The course of pregnancy and teratogenicity of antiepileptic agents in 66 patients with epilepsy].

We report on 79 pregnancies in 66 female outpatients with epilepsy. An increase of seizure frequency was significantly more frequent in complex partial seizures than in grand mal seizures and in absences. The reason for these disparities are not clear.

[Epileptic psychoses and their drug treatment].

This paper is concerned with classification, clinical-electroencephalographic correlation, principles of treatment, and pharmaceutic therapy of epileptic psychoses. Based on the system of the physically founded reversible psychoses, classification of epileptic psychoses is developed, which is easy to apply for clinical and research purposes. Its principles are the criteria of disturbance of consciousness and of connexion to epileptic seizures.

[HMPAO-SPECT in cerebral seizures].

In nine patients with suspected psychogenic seizures and in three patients with proven epileptic seizures HMPAO-SPECT was performed prior to and during seizure. In the patients with later on-proven psychogenic seizures no, or only slight, changes of regional cerebral blood flow were found. Patients with proven epilepsy revealed partly normal findings interictally but during seizure a markedly increased circumscript blood flow was found in all patients.

Double-blind placebo-controlled trial with flunarizine in therapy-resistant epileptic patients.

The anticonvulsant efficacy and side-effect liability of flunarizine (15 mg/day) was investigated in a randomized, double-blind, placebo-controlled, crossover design in 30 outpatients with drug-resistant complex partial seizures. Flunarizine or placebo was added to the preexisting medication and each patient was followed up for 10 months. At the end of the study data from 22 patients were available for evaluation.

Functional and morphological abnormalities in temporal lobe epilepsy: a comparison of interictal and ictal EEG, CT, MRI, SPECT and PET.

Ten patients suffering from drug-resistant complex partial seizures, with EEG abnormalities in the temporal region, were studied by means of non-invasive electrophysiological techniques (video-monitored, 16-channel, prolonged surface and sphenoidal EEG) as well as by imaging techniques (CT, MRI, SPECT and PET). Analysis of interictal and ictal EEG indicated the localization of epileptic activity in one side in eight cases. CT demonstrated focal abnormalities in three, SPECT in five unequivocally (in another four questionably, with the same lateralization as indicated by PET), MRI in eight, and PET in all cases.

Epileptic activity during sleep and wakefulness.

In 23 untreated patients the temporal distribution of generalized spike-wave activity was investigated by means of mobile long-term EEG recordings. Distribution classes (S, A, W) were defined if the relative amount of epileptic activity within the phases sleep, awakening and waking exceeded a threshold, otherwise a diffuse distribution (D) was scored. A, S and D distributions were found approximately with the same frequency.

Studies on the intracerebral metabolism of anticonvulsant drugs--II. Disposition of carbamazepine in the isolated perfused rat brain.

Carbamazepine (CBZ) was perfused (85 nmoles/ml) through the isolated brains of rats. After 2 hr the mean regional concentrations of the drug were between 170 and 234 nmoles/g wet weight. The total brain content of CBZ was 390 nmoles.

Free level monitoring of carbamazepine and valproic acid: clinical significance.

The recently available ultrafiltration technique facilitates determination of the free drug serum concentration of several antiepileptic drugs. For this reason a reappraisal of the clinical significance of free level monitoring was thought necessary. In this study on 203 patients receiving carbamazepine monotherapy and 101 patients receiving valproic acid monotherapy, the total and free drug levels were correlated with therapeutic outcome and side effects.

[Cerebral emission computer tomography (SPECT) with 123I-labeled amphetamines].

Amphetamine is stored by brain tissue and permits its scintigraphic imaging, particularly with the single-photon emission computed tomography (SPECT). A total of 60 scintigraphic investigations in 54 patients were done. Investigations were done using an emission computed tomograph (rotating gamma-camera) after application of 123I-N-isopropyl-amphetamine.

Studies on the intracerebral metabolism of anticonvulsant drugs--I. Perfusion of primidone through the isolated brain of the rat.

Primidone and phenobarbital (each 85 nmoles/ml were separately perfused through the isolated brain of the rat. After 5 min of perfusion similar amounts of primidone and phenobarbital were taken up into the brain; for both drugs the concentration ratio between brain and perfusion medium was about 0.2.

[The spread and inhibition of epileptic processes, findings with the kindling model in the cat].

The study was undertaken to describe some characteristics of subcortical brain activity during the development of an experimentally induced seizure disorder in the cat, as well as to test inhibitory effects of caudate counterstimulation. A further objective was to assess the use of closed circuit TV monitoring for the evaluation of clinical symptoms in an experimental model of limbic epilepsy. The analysis of event related potentials, spectral coherences and phases was especially suitable in order to detect a gradual lowering of the seizure threshold during the establishment of a unilateral Nucl.

Intensive follow-up monitoring in patients with once daily evening administration of sodium valproate.

For 18 previously untreated patients with absence, myoclonic, or grand mal seizures--or combinations--results of clinical and electroencephalographical monitoring are reported. Sodium valproate was given once daily in the evening. Monitoring included repeated 24-48 h EEG recordings and drug blood level measurements.

Effect of valproic acid treatment on spike-wave discharge patterns during sleep and wakefulness.

7 patients suffering from absences were recorded before antiepileptic treatment, in the early phase of valproate monotherapy and after having reached steady state. Recordings made with the Oxford-Medilog 4-channel cassette recorder were analyzed visually as well as by a computerized s-w pattern recognition approach, the latter facilitating quantification of pattern characteristics (number, amplitudes and duration of spikes and waves). Measurements were made separately for epochs of wakefulness and sleep.

A prospective randomised trial on the effect of monitoring plasma anticonvulsant levels in epilepsy.

To evaluated whether knowledge of plasma levels of anti-epileptic drugs has an effect on therapeutic outcome, 127 epileptic outpatients were randomly assigned to two groups (A and B). Plasma levels of group A were reported to the treating physician who attempted to keep the plasma levels within the "therapeutic range." The treating physician was not informed of the results of plasma level determinations of group B.