[Treatment of parkinsonism with L-dopa and peripheral decarboxylase inhibitor]. / Leczenine parkinsonizmu L-dopa i inhibitorem dekarboksylazy obwodowej

In 38 patients with Parkinson's syndrome Madopar preparation was used (L-dopa with peripheral decarboxylase inhibitor) in 33 cases as the main drug and in 5 cases as an addition to L-dopa. In the group of 33 patients 39 could complete the treatment, one patient died suddenly, three had the treatment withdrawn in view of side effects. The effectiveness of Madopar was assessed by means of five-rate scoring systems NUDS and ART. Clinical improvement was found in 22 cases (about 67%). The improvement included mainly bradykinesia and rigidity, while tremor was only slightly improved. Side effects developed in about 40% of patients and were slight and transient (apart from 3 cases). The main contraindications seem to be psychotic disturbances. In the group of 5 cases treated with Madopar as an additional drug in low doses improved the result of long-term treatment with L-dopa.

[Effect of Coretal Polfa (Oxprenolol) on parkinsonian tremor and benign essential tremor]. / Wpllyw Coretalu -- Polfa (oksprenolol) na drzenie parkinsonowskie i na drzenie samoistne

Coretal -- an agent blocking the beta-adrenergic receptors -- was given to 12 patients with Parkinson's syndrome with evident tremor and to 4 patients with benign essential tremor. In the group of Parkinson's syndrome the effectiveness of this treatment was evaluated by the blind method. The whole period of observation was 6 weeks, during 3 weeks the patients received Coretal 60-120 mg daily, during the next 3 weeks they were given placebo. The intensity of tremor was assessed by means of a scoring system. Improvement was achieved in 7 patients with Parkinson's syndrome and in 3 out of 4 cases of idiopathic tremor. Complete disappearance of tremor was never observed. Transient side effects were observed in 2 causes. The authors think that Coretal may be used with good result in treatment of parkinsonian tremor and benign essential tremor.

[Intrathecal administration of interferon in the treatment of SSPE]. / Dokanalowe podawanie interferonu w leczeniu SSPE.

Seven patients with SSPE aged from 10 to 19 years received beta interferon intrathecally one million units every second day during one month (in all, 15 million units for one course of treatment. During the treatment signs were observed of irritation of the meninges which regressed after treatment completion. The neurological status of the patients was not significantly changed during the treatment. Control investigations carried out 3 to 10 months after the treatment demonstrated worsening with progression to a further phase of SSPE in 4 cases, and evidence of disease progression within the previous phase in 3 cases.

[Diagnostic value of radioisotope cisternography in low-pressure hydrocephalus syndrome]. / Wartosc diagnostyczna cysternografii radioizotopowej w zespole nadcisnieniowego wodoglowia.

In the light of pneumoencephalographic investigations and radioisotope scinticysternography carried out in 22 patients with clinical manifestations suggesting the syndrome of Hakim the authors analyse the diagnostic usefulness of both methods. In all cases PEG demonstrated dilatation of the ventricular system, in 10 cases radioisotope cisternography showed abnormal passage of the cerebrospinal fluid, and in 8 of these cases ventricular reflux was found lasting at least 24 hours, while in 2 other cases absorption of the cerebrospinal fluid was impaired. On the basis of this material the authors believe that in cases of presence of ventricular reflux this investigation is very important for undertaking the decision of surgical treatment, besides that, the authors think that despite normal scintigraphic pattern in early stage of the disease the investigation should be repeated after from 10 to 20 months, since clinical symptoms may precede disturbances of cerebrospinal fluid passage detectable in cisternographic investigation.

[Characteristics of the clinical features and pharmacological treatment of epileptics with frequent seizures]. / Charakterystyka cech klinicznych i leczenia farmakologicznego u chorych na padaczke z czestymi napadami.

The analysis of clinical features of groups of patients with frequent and rare epileptic seizures showed that the mean age of the first seizure, the mean age at the time of examination, and the mean duration of the disease were not significantly different in both studied groups. In the group with frequent seizures a significantly more frequent presence of features indicating serious organic brain damage was found (more frequent occurrence of known aetiological factors, more cases of posttraumatic epilepsy, psychic and neurological abnormalities). In group C changes in the background activity in EEG were also more frequent. The analysis of pharmacological treatment showed a more frequent application of polytherapy in group C. On the other hand, the mean levels of antiepileptic drugs in the serum and the mean doses of these drugs for kg of body mass were not significantly different in both groups. In about 40% of patients in both groups the prescribed drugs failed to reach the levels generally regarded as therapeutic (slightly more frequently in the group with rare seizures). This was true mainly of PHT since about 81% of patients in both groups failed to reach the therapeutic level of the drug (10 ug/ml). The likely causes of this fact were: too low doses prescribed (55% of the patients were given doses below the generally recommended), lower bioavailability of PHT (27% of patients had no therapeutic level of the drug in the serum, despite doses exceeding 5 mg/kg); or drug interaction. This requires elucidation in further studies.

[Epilepsy and self evaluation of health conditions in subjects with a history of severe head injury in childhood]. / Padaczka i ocena wlasnego stanu zdrowia u osób, które w dzecinstwie doznaly ciezkiego urazu glowy

Follow-up study of 309 subjects were carried out. They gave a history of severe head trauma in childhood (with cerebral concussion or cranial fracture). The mean age of these subjects at the time of trauma was 6.3 years and at the time of examination -- 19.3 years, the mean duration of follow-up being about 13 years. The frequency of epilepsy in this group was 3.2/1000 before head trauma. In follow-up prevalence of epilepsy in this groups was 25.9/1000, and of suspected epilepsy prevalence was 13/1000. The prevalence of epilepsy in subjects after severe head trauma was three times the expected one (9/1000). The most frequent complaint in this group were headaches. They were twice as, frequent as in the general population at the same age. The proportion of subjects regarding their health state as poor was nearly twice as high as expected, and that of subjects regarding it as good was by one-third lower than expected. Despite these differences in self-evaluation of the health state and frequency of complaints it was found that a higher proportion of subjects in this group had not visited doctors in the year preceding the investigation than in the general population. This may indicate that many subjects in this group have lost motivation for treatment.

[Epileptic seizures among the population of Mokotów: incidence and prognosis]. / Napady padaczkowe w populacji Mokotowa: zapadalnosc i rokowanie.

In the years 1976-1979 all cases of first epileptic seizure of any type were analysed in the whole population of the Mokotów District. The total number of patients with the first seizure in life was 272. The mean annual incidence coefficients were: for the repeatedly occurring seizures (i.e.epilepsy)--21.2/100 thousand of the general population, including 25.3 for men and 17.5% for women; isolated seizures--8.0 and 10.1 and 6.1 respectively; febrile seizures (diagnosed in children aged up to 4 years)--12.9 and 15.6 and 10.4 respectively; in another 2.3 subjects per 100 thousand the reported seizures were suspected of being epilepsy. It may be stated, generally, that in each 100 thousand of the population 44 subjects require annually examination because of epileptic seizure of seizures (or a disease in which seizures were one of its signs). The incidence was higher in men than in women (54 and 36 respectively). Epilepsy incidence coefficients and similar coefficients of isolated seizures were low in the first two decades of life, rising then gradually to a maximal level at the age of 70 and more years (60,3/100 thousand). The aetiology of the disease was disclosed in 70% of cases: head trauma in 20%, chronic alcoholism in 16%, stroke in 12%, brain tumour in about 10%. These were the most frequent aetiological factors. During follow-up 31 patients died, mostly the cases of brain tumour (40%), stroke (29%) and intracranial haematomas (about 10%). EEG obtained shortly after the first seizure is of low prognostic value.