[Bad aftertaste caused by pine nuts]. / Een vieze smaak in de mond door pijnboompitten.

BACKGROUND: Dysgeusia caused by the consumption of pine nuts is not widely reported in the medical literature, although much is written about this condition on the Internet. CASE DESCRIPTION: We present the case of a 46-year-old male who complained of metallic and bitter dysgeusia that started 2 days after the ingestion of approximately 70 grams of pine nuts. A literature search revealed only 3 case reports on this subject. In all cases including ours, the complaints began a few days after the ingestion of pine nuts and had spontaneously resolved after a week. No medical sequelae are known, but patients may suffer social consequences. CONCLUSION: The cause of this condition is unknown. Possible causes include the presence of toxic or inedible components in the pine nuts. Physicians should be aware of this phenomenon in order to be able to reassure patients about this benign disorder.

[Epilepsy from seizure to care]. / Epilepsie van aanval tot zorg.

Epilepsy is very common. The prevalence in the Netherlands is 5:1000 inhabitants. The diagnosis is mostly made on clinical grounds and often incorrectly. If there are doubts about the diagnosis, the patient can be referred to a specialised centre for a seizure registration with an EEG and video recording. The disorder generally responds well to treatment with anti-epileptics. Some 60-70% of patients treated with these remain free of seizures. If medicinal treatment fails then a surgical intervention can be considered. For patients with temporal epilepsy in particular, there is quite a high chance that a surgical intervention will resolve the symptoms. Where it proves difficult to satisfactorily adjust the medication of a patient, stimulation of the left vagus nerve can be considered. Paying more attention to the side effects of the medication and the limitations imposed on the patients can reduce the negative influence of epilepsy on the quality of life.