Strange episodes during sleep - epilepsy or parasomnia? / Underlige episoder under søvn ­ epilepsi eller parasomni?

In some forms of epilepsy, the seizures occur almost exclusively during sleep. This is particularly the case with hypermotor frontal lobe seizures. Clinically it can be difficult to distinguish such seizures from parasomnias and psychogenic non-epileptic seizures. This clinical review article aims to highlight the importance of making the correct diagnosis, as these conditions require completely different treatment.

[Foot disease in Icelandic patients with established type 2 diabetes]. / Einkenni og teikn fótameins hjá íslenskum sjúklingum med sykursýki af tegund 2.

OBJECTIVE: To assess the prevalence of symptoms and signs of diabetic foot disease in patients with established type 2 diabetes (T2DM) in Iceland and compare it to controls without diabetes. MATERIALS AND METHODS: Participants were 41 individuals (age range 48 to 75 years), with diabetes of at least 8 years duration, birth date between 1925 and 1965 who were living in the greater Reykjavik area. The control group consisted of 34 spouses without diabetes (age range 43 - 77 years). RESULTS: The most common symptom was leg cramps which affected 37% of patients with T2DM and 29% of controls (difference not statistically significant). Moderate or severe symptoms indicating neuropathy were found in 39% of T2DM patients and in 27% of controls (difference not statistically significant). Intermittent claudication was present in 29% of patients with T2DM and 9% of controls (p<0.03). Based on both symptoms and signs, neuropathy was considered present in 12% of patients with T2DM but none of the controls (p<0.04). The most common sign was dry skin, present in 51% of patients with T2DM and in 18% of controls (p<0.003) while abnormal vibration perception was found in 34% of patients with T2DM and 12% of controls (p<0.003). Abnormal pressure sensation was found in 20% patients with T2DM and 3% of controls (p<0.003). Peripheral macrovascular disease was considered present in 15% of each group. CONCLUSION: Symptoms and signs from feet are common in adult individuals, regardless of diabetes. The observed prevalence of peripheral diabetic neuropathy is among the lowest published. The assessment of diabetic foot disease needs to be standardised, multimodal and take account of both symptoms and signs.