Do males 30-50 years of age with chronic epilepsy and on long-term anticonvulsant medication have lower-than-expected risk of developing coronary heart disease?

Purpose: It has been claimed that long-term use of antiepileptic drugs (AEDs) brings about changes in the lipid profile which might resist development of cardiovascular disease. The aim of this study was to test the following hypothesis: Do males with chronic epilepsy and on long-term treatment with AEDs have a lower than expected risk of developing coronary heart disease?

Methods: The coronary risk profile in 40 male patients with chronic epilepsy, aged 30-50 years, was explored, using an American individual coronary risk factor test program (the Cooper test). We made a survey of the patients' risk factors: total cholesterol, high density lipoprotein (HDL) cholesterol, triglycerides, glucose, blood pressure, body fat percentage, physical fitness, hereditary factors, smoking habits, and degree of stress.

Neuropsychological course after surgery for intracranial aneurysms. A prospective study and a critical review.

Previously, only three studies with representative samples of patients with ruptured intracranial aneurysms have provided detailed results of prospective, repeated, neuropsychological assessments after surgery. These studies apparently disagree with regard to occurrence of cognitive deficits and to degree of improvement between early and delayed follow-ups. The present paper attempts to analyze the conditions underlying these differences in results.

Simulation of the influence of different factors on the motor nerve condition velocity measurement. Part 1: Normal conditions.

The result of a motor nerve conduction velocity measurement is dependent of a row of factors which will influence the measurement. These factors have been tested extensively in healthy volunteers. However, under pathological conditions it is not known to what degree the reported velocities are influenced by biological and technical factors.

Does physical exercise influence the occurrence of epileptiform EEG discharges in children?

Purpose: To determine if, and how, epileptiform EEG discharges in children were influenced by physical exercise.

Methods: Twenty-six children with intractable partial and generalized epilepsy exercised during video-telemetry recording, aiming at exhaustion after approximately 10 min.

Results: During the exercise, epileptiform discharges decreased in 20 of 26 children (17 children had at least 25% reduction) and showed a rebound increase after the exercise (17 of 26 children) compared to baseline conditions.

Does a sedative dose of chloral hydrate modify the EEG of children with epilepsy?

Chloral hydrate (CH) is used to sedate children unable to cooperate during investigations such as EEG requiring the patient to be still. It is not known if CH or its metabolites modify the EEG and our aim was to answer this question. Recordings of the EEG before, during and after rectal administration of CH (50-77 mg/kg) in 13 children aged 1.

Pharmacokinetics and interaction profile of topiramate: review and comparison with other newer antiepileptic drugs.

Standard antiepileptic drugs (AEDs) have a number of pharmacokinetic shortcomings, and AEDs with more favorable profiles would be preferred. The pharmacokinetics and interaction profile of the recently developed AED topiramate (TPM), is reviewed and compared with those of other newer AEDs including lamotrigine (LTG), gabapentin (GBP), vigabatrin (VGB), and oxcarbazepine (OCBZ). Although none of these agents meets all of the criteria of the "ideal" AED from the pharmacokinetic standpoint, a number of these drugs, including TPM, have desirable properties that distinguish them from the older AEDs and should contribute to their clinical utility.

Patient satisfaction and epilepsy surgery.

This study was designed to describe patients' experience with surgical treatment of epilepsy in terms of whether it was useful or had negative effects and to assess associations between experienced utility (satisfaction), experienced negative effects (dissatisfaction), and selected objective outcome measures. An evaluation of patients' satisfaction and dissatisfaction was conducted retrospectively by questionnaires for all patients surgically treated for epilepsy in Norway between 1949 and 1988. One hundred sixteen patients (74.

Epilepsy surgery: non-invasive versus invasive focus localization. What is needed from a neurological point of view?

Epilepsy surgery should be performed as early as possible when intractable seizures are diagnosed together with a well-defined focus in a resectable part of the brain. All patients with epilepsy, and especially all children with epilepsy, should therefore be followed by a neurologist or a child neurologist specially trained in epileptology.

Seizure-related injuries in multihandicapped patients with therapy-resistant epilepsy.

A prospective study on seizure-related injuries in Norway's two nursing homes for persons with epilepsy was conducted. Sixty-two multihandicapped patients with mostly difficult-to-treat epilepsy were assessed for 13 months: 6,889 seizures, 2,696 with ensuing falls, resulted in 80 injuries. The seizure-related injury risk was 1.

Surgical versus medical treatment for epilepsy. II. Outcome related to social areas.

We conducted a retrospective parallel cohort study comparing surgical and medical treatment for epilepsy. The surgical group contained all 201 patients treated with resective surgery for epilepsy in Norway since the first operation in 1949 until January 1988. The 185 patients in the control group, medically treated only, were closely matched for year of treatment, age at treatment, sex, seizure type, and neurologic deficit before treatment.

Surgical versus medical treatment for epilepsy. I. Outcome related to survival, seizures, and neurologic deficit.

We conducted a retrospective parallel longitudinal cohort study comparing surgical and medical treatment for epilepsy. The surgical group contained 201 patients treated with resective surgery for epilepsy in Norway since the first operation in 1949 until January 1988. The 185 control group patients treated medically only were closely matched for year of treatment, age at treatment, sex, seizure type, and neurologic deficit before treatment.

[Role of drug assays in the treatment of epileptic patients].

Drug assays play an important role in the control of antiepileptic treatment because the relationship between the serum concentration of an active drug and its therapeutic effects and side-effects is closer than between dose and effect. Bioavailability, protein binding and drug elimination are subject to inter- and intraindividual variations. However, it is important to remember that the optimal therapeutic ranges reported for serum levels are only a guideline to drug therapy.

Effect of physical training on aerobic capacity, seizure occurrence, and serum level of antiepileptic drugs in adults with epilepsy.

Twenty-one adult in-patients (11 women, 10 men, aged 18-39 years) with uncontrolled epilepsy participated in a 4-week intensive physical training program, exercising for at least 45 min three times a day, 6 days a week, at an intensity of minimum 60% of maximum oxygen uptake (maximum VO2). The program induced a considerable increase in maximum VO2 (mean 19%). Beneficial psychological and social effects were also recorded.

Neuropsychological assessment of cognitive functioning in children with epilepsy.

The variety of cognitive dysfunctions related to learning disabilities in children with epilepsy have been studied by linking electroencephalogram (EEG) and computerized neuropsychological testing. This showed that "subclinical" discharges impaired performance in 61% of the patients on a simple and a choice reaction time test, although some discharges lasted 1 s only. Neuropsychological investigation of subclinical EEG discharges may help to determine their adverse effect on learning.

Education and epilepsy: assessment and remediation.

Learning difficulties in children with epilepsy may be caused by brain damage and should be investigated. In many cases, however, seizures and/or electroencephalographic (EEG) findings are the only signs of pathology. Frequency and type of seizures may be determining factors that should, if necessary, be evaluated by long-term EEG monitoring, preferably during school performance or in conjunction with neuropsychological assessment.

Surgical treatment of epilepsy. Clinical aspects in children.

Neurosurgery, mainly temporal lobectomy, has given substantial relief of serious seizure problems in two-thirds of children with intractable epilepsy. Since the prognoses of children with an intractable epilepsy is poor, surgery should be considered. To prevent sequela of a long standing seizure disorder and side effects of antiepileptic medication as well as the development of mirror foci, surgery should be considered at an early age.

Surgical treatment of epilepsy. Organization (localization, staff, referral procedures).

Small countries like Norway (4.2 mill. people), should centralize surgical treatment for epilepsy around a permanent team from one comprehensive epilepsy service center and the cooperating university regional hospital.

Specific problems of children with epilepsy.

In both adults and children, the seizure type and frequency of occurrence largely determine the burden of epilepsy, for the patient and his family. Epilepsy in children can range from the severe to the relatively benign, and it is important to make the correct diagnosis as early as possible. In those under 5 years of age, epilepsy often presents as an age-related syndrome, e.

Consequences of severe epilepsy: psychosocial aspects.

Patients with severe epilepsy very often present a diversity of problems which interact with each other and with factors in the environment in subtle ways. Intellectual and social shortcomings as well as anxiety-related emotional problems are among the most common primary and secondary consequences seen in this patient group. Anxiety among the relatives, ignorance and prejudice in the general population often add to the patients' burdens.