[Epilepsy and the functional organization of the autonomic nervous system].

Results of the studies on the state of the autonomic nervous system (ANS) in symptomatic temporal epilepsy (TE) and frontal epilepsy (FE) are presented. It was investigated the functional state of catecholamine system, autonomic background, reaction and ANS supply in response to the physical and psycho-emotional tests according to the clinical data, psychological testing and evaluation of the skin sympathetic response (SSR) as well as EEG parameters (paroxysmal index, slow activity in the background and in response to hyperventilation). The control group included healthy subjects. Comparison groups consisted of patients with panic attacks or with the combination of epilepsy and panic attacks. The disturbance of the self-regulation of catecholamine system and its exhaustion in TE were identified. The authors suggested the concept of the denervation hypersensitivity. According to the SSR, a start of the response to external stimuli always begins from the parasympathetic reaction both in healthy people and in all groups of patients studied. It means that the stable adaptive mechanism in the form of anticipating reaction from the side of the mechanisms stabilizing homeostasis had been formed during the phylogenies. Different patterns of the disturbance of ANS functional state in TE and FE were established. The data obtained indicate that the neocortical motor cortex has a direct relation to the suprasegmental formations which realize the ergotrophic supply of the motor activity.

[Autonomic dysfunction in patients with temporal lobe epilepsy]. / Vegetativnaia disfunktsiia u bol'nykh visochnoi épilepsiei.

In 102 patients with temporal epilepsy autonomic (tone, responses, effectiveness) and sympathoadrenal (urine excretion of catecholamines and its changes under effects of epinephrine, insulin and L-DOPA administration) systems were investigated. Some of the indices under study showed reliable correlations with clinical data. Pronounced alterations of autonomic functions were found. The data suggest an important role of catecholamines in the pathogenesis of temporal epilepsy.

[Reactivity of the DOPA--dopamine--noradrenaline--adrenaline system in epileptics]. / Reaktivnost' sistemy DOFA--dofamin--noradrenalin--adrenalin u bol'nykh épilepsiei.

Epileptic patients were examined for the daily urine elimination of DOPA, dopamine (DA), noradrenaline (NA), and adrenaline (A). The changes in the excretion of these substances after L-DOPA intake and the adrenaline and insulin test were also investigated. In addition to the evidence about the preserved reactivity of the DOPA-DA-NA-A system to L-DOPA intake, data were obtained pointing to its strain and a reduction in the reserve potentialities. The use of the adrenaline test disclosed the absence of, or a negative response on the part of DA and A in half of the patients, which correlated with definite clinical parameters. In one third of the patients, the insulin test was not accompanied by any increase in the excretion of A or its precursors. The findings obtained are indicative of the insufficiency of homeostatic reactions in epileptics and, possibly, of the deficit of the repolarizing mechanisms.

[Petit mal status epilepticus with unusual clinical manifestations]. / Epilepticheskii status malogo pripadka s neobychnymi klinicheskimi proiavleniiami.

A unique observation of an epileptic female examined in detail in a neurological clinic is presented. The patient was later hospitalized 3 times for disturbances of consciousness and extrapyramid disorders characterized by acute onset. An encephalographic examination carried out during such a state showed an epileptic status of atypic absence. The development of the Parkinsonian syndrome is regarded as a proof of the role of the caudate nucleus in the genesis of the petit mal epileptic status.