[The course of epilepsy in girls at the age of puberty]. / Przebieg padaczki w okresie pokwitania u dziewczat

In 62 women the course of epilepsy was analysed at the age of puberty from 11 to 15 years of life. In 19 cases the course of the disease remained unchanged at that time, in 20 cases the seizures disappeared or became less frequent, in 20 cases the frequency of seizures increased, other types of seizures developed, or seizures present previously in childhood reappeared. The unfavourable change in the course of disease was observed more often in girls with onset of the disease at an early age, frequent seizures at the beginning of the disease, partial combined seizures, neurological and psychic abnormalities and with delayed menarche in relation to the general population.

[A case of coexistence of hypophyseal adenoma and epileptic seizures]. / Przypadek wspólistnienia gruczolaka przysadki i napadów padaczkowych.

A case of hypophyseal adenoma with epileptic seizures in a man aged 61 years is reported. The generalized seizures developed 21 years earlier, and partial complex seizures 2 years before the diagnosis of adenoma. The patient had two sons, one died of suprasellar tumour, the other one has generalized and partial complex seizures.

[Choreoathetotic movements in a patient with epilepsy after treatment with diphenylhydantoin]. / Wystepowanie ruchów plasawiczo-atetotycznych u chorego na padaczke w nastepstwie leczenia difenylhydantoina.

The authors describe a very rare case of choreoathetotic movements which appeared in an epileptic in strict relationship to a toxic concentration of diphenylhydantoin in the serum. These movements were reversible and disappeared after reduction of drug dose and its serum concentration falling to the therapeutic range.

[Case of postpregnancy diencephalosis with manifestations of psudotumor cerebri]. / Przypadek zespolu podwzgórzycy pociazowej z objawami rzekomego guza mózgu

The authors report a female patient with postpregnancy diencephalosis in whom in close correlation with premenstrual tension syndrome acute cerebral oedema developed repeatedly with signs of tentorial herniation. Owing to treatment with substitutive cyclopeptide hormones stimulating secondarily the failing hypophysis complete disappearance of these signs was obtained.

[Urinary excretion of 17-hydroxycorticosteroids and 17-ketosteroids in women with epileptic seizures during the premenstrual period]. / Ilosci wydalanych w moczu 17-hydroksykortykosterydów oraz 17-ketosterydów przez kobiety z napadami padaczkowymi w okresie poprzedzajacym krwawienie miesiaczkowe

The authors determined the amounts of free and total 17-hydroxycorticosteroids (17-OHCS) and 17-ketosteroids (17-KS) in the urine of 11 women in whom epileptic seizures occurred most frequently on the 2nd and 1st day before menstruation and in 7 women with seizures showing no such correlation with the menstrual cycle. A statistically significant decrease of 17-KS was demonstrated in women with premenstrual seizures. In both groups of women the amounts of free 17-OHCS were near the lower normal range, while the amounts of total 17-OHCS were reduced and the obtained results compared with the accepted normal values showed statistically significant differences (p less than 0.01). The obtained results are, however, insufficient for assuming that these hormones play an important role in the mechanism of seizure release in premenstrual period. The authors think, on the other hand, that the statistically significant fall in 17-KS in women with premenstrual seizures may play some role among other factors in the mechanism of seizure release.

[Urinary excretion of estrogen fractions, alpha and beta pregnanediol and pregnanetriol in women with epileptic seizures during the premenstrual period]. / Ilosci wydalanych w moczu frakcji estrogenów alpha i beta-pregnandiolou i pregnantriolu przez kobiety z napadami padaczkowymi w okresie poprzedzajacym krwawienie miesiaczkowe

The authors determined the amounts of oestrone, oestradiol, oestriol, alpha and beta pregnanediol, and pregnanetriol in 24-hour urine of 11 women with epileptic seizures occurring two and one day before the onset of menstruation, and in 7 women with seizures not dependent on the menstrual cycle. Determinations of these hormons were done during three successive menstrual cycles on the 2nd and 1st day before the onset of bleeding. In both groups a significant decrease was observed in the urinary levels of oestradiol and oestriol as compared with normal values. On the other hand, the amount of excreted oestrone was only slightly lowered in relation to the amount of this hormone excreted by controls. A significant decrease in the amounts of alpha pregnanediol (the difference being statistically significant at p less than 0.01 level) was observed two days before menstruation. On the other hand, pregnanetriol was decreased only in women in whom the seizures showed no temporal correlation with the stage of the menstrual cycle. The authors suggest that the observed reduction in the metabolites of progesterone in both groups was associated with an increased seizure readiness of the brain on the days preceding menstrual bleeding.

[Evaluation of the secretory activity of the adrenal cortex and gonads in women with epilepsy. I. Urinary excretion of metabolites of adrenal cortex hormones in women with epilepsy during the 2 days preceding menstrual bleeding]. / Ocena czynnosci wydzielniczej kory nadnerczy i gonady u kobiet chorych na padaczke. I. Wydalanie metabolitow hormonow kory nadnerczy z moczem u kobiet chorych na padaczke podczas dwoch dni poprzedzajacych krwawienie miesiaczkowe.

In 32 women with seizures occurring mainly in the premenstrual phase and during bleeding, (group A) and in 31 women with epilepsy without this relationship of the seizures to the menstrual cycle (group B) the metabolites of adrenocortical hormones (17-ketosteroids and 17-hydroxycorticosteroids) were determined in 24-hour urine. The investigations were done during 2 days preceding menstrual bleeding, in most cases during three menstrual cycles. A significant reduction of the excretion of 17-ketosteroids and total 17-hydroxycorticosteroids was found in both groups as compared to the accepted normal value (p less than 0.01). However, no significant difference was observed in the excretion of these hormones between these groups of patients, although in group A he values of 17-ketosteroids were lower than in group B. On the basis of these results it is suggested that deficiency of androgenic hormones may contribute to the occurrence of seizures on the days before the onset of menstrual bleeding, and the effect of anticonvulsant treatment on the decreased excretion of these hormones is discussed.

[Evaluation of the secretory activity of the adrenal cortex and gonads in women with epilepsy. II. Urinary excretion of estrogen fractions and alpha and beta pregnanediol during the 2 days preceding menstrual bleeding]. / Ocena czynnosci wydzielniczej kory nadnerczy i gonady u kobiet chorych na padaczke. II. Wydalanie z moczem frakcji estrogenow oraz alfa i beta pregnandiolu podczas dwoch dni poprzedzajacych krwawienie miesiaczkowe.

In 32 women with epileptic seizures related in time to the premenstrual phase (group A) and 31 women with seizures unrelated to this phase (group B) oestrone oestradiol and oestriol and progesterone metabolites (alpha and beta-pregnanediol) were determined in 24-hour urine. The investigations were carried out during 2 days preceding the onset of menstrual bleeding usually during three successive cycles. A significant reduction was observed in the amounts of all three oestrogen fractions in relation to normal values on both days (without any significant difference between the groups). Women with epilepsy excreted 56-60% less oestrogens than healthy women. Similarly the levels of alpha and beta-pregnanediol were significantly below the accepted normal range. The obtained results are insufficient for accepting the role of oestrogens in the development of lowered convulsive threshold on the days preceding menstrual bleeding. On the other hand, it may be concluded that progesterone deficiency may have an effect on the appearance of greater readiness to seizures before menstruation in epileptic women.

[Changes in cytohormonal cervical swabs in epileptic women]. / Wystepowanie zmian w rozmazach cytohormonalnych u kobiet chorych na padaczke

In 16 women with epilepsy aged 18 to 38 years cytohormonal investigations were carried out during menstrual cycle. Swabs were obtained from the upper one-third of the vagina, fixed and stained by the method of Schorr. Oestrogen activity indices (PI, EI, MI) and progesterone activity indices (FI, CI) were calculated. With the exception of 2 cases in all patients the cycles were abnormal. In 1 cycle high values of oestrogen activity indices were found. In 13 patients (80%) monophasic, hypoestrogenic, cycles were observed without progesterone activity in the second phase of the cycle. The authors believe that very long anticonvulsant treatment as well as lower efficiency of the hypothalamo-hypophyseal system may reduce the level of steroid hormones produced by the ovaries which must, however, be confirmed by further clinical and experimental investigations.

[Change of diphenylhydantoin tolerance at the time of reaching puberty in a 16-year-old girl suffering from epilepsy]. / Zmiana tolerancji na dwufenylhydantoine w okresie pokwitania u 16-letniej chorej na padaczke

During a 3-year period of treatment with DPH three episodes of drug intolerance developed in a 16-year-old epileptic girl. The dose tolerated previously was 200 mg daily. The authors stress the effect of hormonal disturbances on the change in DPH tolerance.

[Analysis of changes in the incidence of seizures in pregnant women with epilepsy]. / Analiza zmiany czestosci napadów podczas ciazy u 65 kobiet chorych na padaczke.

Sixty-five (41%) of 153 pregnant women with epilepsy were selected for analysis because the course of the disease changed in them during pregnancy. In 43 of these women (67%) the frequency of seizures decreased and in 21 cases the seizures disappeared completely. In 22 patients (33%) the frequency of seizures increased in pregnancy. An unfavourable influence of pregnancy was observed more frequently in patients with vourable influence of pregnancy was observed more frequently in patients with severe epilepsy with evidence of organic changes in the central nervous system and mental changes. The prognosis was better in women with less severe disease continuing anticonvulsant treatment.

[Severe case of basilar migraine treated with flunarizine]. / Ciezka postac migreny podstawnej z dobrym efektem zapobiegawczym flunaryzyny.

In a man aged 40 years frequent attacks of basilar migraine with consciousness disturbances and signs of central nervous system defects developed due to circulatory failure in the posterior cerebral arteries and cerebellar arteries. The frequency and intensity of migraine attacks decreased only after treatment with flunarizine.

[Serum luteinizing hormone (LH) level during menstrual cycle in women treated for epilepsy]. / Poziom hormonu luteinizujacego (LH) w surowicy krwi w cyklu miesiecznym u kobiet leczonych z powodu padaczki.

In 22 women aged 18 to years treated for epilepsy with phenytoin (DPH) and phenobarbital (PB) the serum levels of LH were determined by radioimmunoassay on 8 days of various phases of the menstrual cycle. In 10 cases the attacks were related in time to the premenstrual phase of the cycle (group A), in 12 cases no such correlation was observed (group B). These results were compared with the results of similar investigations carried out in 8 women treated in hospital for ischalgia who received also DPH and PB or only PB (group C). A statistically significantly lower level of LH was found in group A in relation to groups B and C on the 13th and 22nd days of the cycle. Decreased LH level on the 22nd day may suggest that in women with attacks related to a phase of the menstrual cycle the corpus luteum may be failing with resulting deficiency of progesterone, which may be one of the factors increasing the readiness to attacks in the premenstrual phase. It may be supposed that DPH and PB given to patients with epilepsy may reduce the serum LH level.

[Serum levels of vitamin B12 in epileptic patients treated with carbamazepine]. / Poziom witaminy B12 u chorych na padaczke leczonych karbamazepina.

In 21 epileptic patients (11 females and 10 males) aged 18-55 years on carbamazepine (CBZ) therapy the serum levels of vitamin B12 were measured. Mean serum level of vitamin B12 in epileptic patients was in the same range as compared to the values in healthy subjects. However, there were differences depending on the drug dose, treatment duration and course of epilepsy. The mean serum level of vitamin B12 was lower in epileptic patients with earlier age of disease onset, frequent seizures and with higher drug dose (above 600 mg/d). In patients treated longer than 15 years the vitamin B12 serum level amounted to 65 per cent of the values in control group.

[Adult age phenylketonuria with extrapyramidal syndrome: therapeutic management]. / Fenyloketonuria wieku dojrzalego z zespolem pozapiramidowym--postepowanie terapeutyczne.

A young male with phenylketonuria diagnosed in his 9-th month of life is presented. At the age of 20 years signs of central nervous system involvement became more pronounced, with extrapyramidal syndrome and with simultaneous very striking increase of phenylalanine level. The neurological signs were reduced after administration of Levodopa (Nakom) and return to more strict diet and Lofenalac.

[Neurocysticercosis: benign natural course]. / Wagrzyca mózgu: lagodny przebieg naturalny.

In a waiter aged 51 without clinical symptoms, but with a history of sporadic epileptic seizures in young age, radiological examination demonstrated multiple calcifications in the brain corresponding to calcified cysticerci. Similar lesions were found in the muscles of the thighs and left lower leg. After another 18 years without cerebral symptoms these calcifications were demonstrated in CT. The case indicates that the natural course of cerebral cysticercosis may be asymptomatic or oligosymptomatic, and that it is useful to distinguish between active and inactive cysticercosis.

[Serum ACTH levels in patients treated for epilepsy]. / Poziom kortykotropiny (ACTH) w surowicy chorych leczonych z powodu padaczki.

In 27 epileptic patients (16 females and 11 males) aged 23-61 years, the serum ACTH levels were estimated by radioimmunoassay (RIA). The men serum ACTH level in epileptic patients was lower than in control group. In epileptic patients there were differences depending on the course of epilepsy and treatment applied. There were lower mean serum ACTH levels in patients with earlier age of epilepsy onset, frequent seizures and generalized discharges in eeg records. Lower serum ACTH amounts were found in patients with long-term treatment with phenytoin and polytherapy applied. It may be supposed that in patients long-term treated because of epilepsy the hormonal disturbances involve not only adrenal cortex but also higher parts of neuroendocrinological system.

[Antibodies for DNA and RNA viruses in the serum of myasthenia patients. Preliminary report]. / Przeciwciala dla niektórych wirusów dna i rna w surowicy chorych na miastenie. Doniesienie tymczasowe.

The reported material included 14 patients with myasthenia and 14 healthy controls. Serum samples were taken for investigations twice at intervals of several weeks. The titres of antibodies against adenoviruses, cytomegalovirus and herpes virus were determined in the complement fixation reaction using antigens from tissue cultures of viruses. The level of antibodies against influenza viruses A1, A2, and B, rubella nad measles viruses was determined using the test of haemagglutination inhibition. In the myasthenic patients serological investigations demonstrated a higher level of antibodies against the studied viruses as compared with controls. The greatest differences were observed in the levels of antibodies against cytomegaloviruses. In 12 patients cytomegalovirus antibodies were found in serum dilutions from 1:4 to 1:64.. On the other hand in the control group in 5 cases positive results were obtained and the titres of antibodies ranged from 1:4 to 1:16. These data are in agreement with the results of investigations reported by American authors who put forward the hypothesis that persistent cytomegalovirus could be a factor releasing autoimmune reactions of the thymus.

[Contribution to the clinical polymorphism in Huntington's disease]. / Przyczynek do polimorfizmu klinicznego w chorobie Huntingtona.

A family is described in which closely consanguineous parents had Huntington chorea and in their son a severe hypertonic-hypokinetic syndrome with pellagra-like cutaneous changes was present. In two generations of the family in 6 subjects involuntary movements and gait disorders were reported.

[Observations on the development of pregnancy in women with epilepsy based on analysis of protein placental hormones and alpha fetoprotein]. / Obserwacja rozwoju ciazy u kobiet chorych na padaczke w oparciu o oznaczenia bialkowych hormonów lozyskowych i alfa-fetoproteiny.

In 19 women with epilepsy the radioimmunoassay determinations in the serum were carried out of human chorionic gonadotropin (HCG), chorionic somatotropin (HPL) and alpha-fetoprotein. The concentrations of placental hormones were not abnormal, but from the 15th week on a rise in AFP level was observed. In the group with raised AFP level the patients received higher doses of phenytoin. In some cases the AFP level exceeded severalfold that in healthy women. One woman with raised AFP gave birth to a premature newborn which died on the 3rd day, another newborn in this group had congenital anomalies (cerebral hygromas). Although placental dysfunction was not observed in this group, but considering a high proportion of surgical interventions during labour (20%) and raised AFP level, pregnancy in epileptic women should qualify them into high-risk pregnancies requiring particular obstetric care.