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Biomedical subjects

A Romaniak

Publications and source records attributed to A Romaniak.

5 recordsLinked to original sources

[Electroencephalographic studies of family members of patients with juvenile myoclonic epilepsy].

Juvenile myoclonic epilepsy (JME) is a common idiopathic generalized epilepsy (IGE); it has a clinical and probably a strong genetic relation to the other IGE forms. Generalized spike/polyspike-wave discharges (SW/PSW) are typical of all IGEs. The aim of our study was to determine the incidence of epilepsy and SW/PSW in EEG of family members of 12 JME patients. 35 first degree relatives aged over 15 years were examined. 40 min EEG with 5 min HV were recorded. IGE was diagnosed in 3 (8.6%) persons: JME in 2 and childhood absence epilepsy (CAE) in 1 person. Six more relatives (17.1%) had typical SW/PSW traits in EEG. Thus the IGE features were found in 9 (25.7%) individuals--members of 7 out of 12 families (58%). EEG of 7 other relatives (20%) revealed non-specific episodic diffuse or focal abnormalities. The above results reveal higher incidence of different kinds of ICEs and typical EEG traits in families of JME patients. This findings confirm familial susceptibility to IGE and may be helpful in genetical counselling.

Adolescent↗

[Epileptic seizures in post-stroke patients].

We were investigating the frequency of early (within 30 days) and late (within 12 months) poststroke epileptic seizures, in our group consisting of 483 patients with stroke (423 cases of ischaemic stroke and 60 cases of haemorrhagic stroke) and without prior diagnosis of epilepsy. In 28 (5.8%) cases early seizures were observed. The most common type of early seizures were generalised seizures, slightly less frequent were simple partial seizures. EEG usually showed focal slow waves or non-specific slowing of background activity. Among 195 one-year survivors late seizures occurred in 6 (3.1%). 5 of them had ischaemic stroke. 30 day and 12 months fatality in the group of patients with seizures was not significantly higher than in all stroke patients.

Adult↗

[Clinical-electrophysiological pattern of juvenile myoclonic epilepsy].

18 patients (9 females, 9 males) with juvenile myoclonic epilepsy (JME) were studied. Despite a fairly long duration of the disease (from 1 to 34 years--mean 9.5 years) the patients had not been properly diagnosed. In all cases routine serial EEG examinations, 24-hour EEG with Medilog System 9000, and polygraphic Video/EEG/EMG recording were done (Videometry Processor, Glonner). Typical attack triads occurred in 7 cases (39%), grand mal seizures and myoclonic attacks in 10 cases (56%), one patient had only myoclonic seizures. EEG demonstrated already in routine recording occurrence of seizure activity with spike/polyspike-slow wave 3-6 Hz complexes. 24-hour EEG made possible demonstration of these complexes in the remaining 4 cases. Seizure activity during clinical myoclonic seizures were recorded in 8 cases, and during absences in 2 cases. A valuable method was also Video/EEG/EMG recording which showed occurrence of both myoclonic seizures (in 5 cases) and absences (9 cases). Three patients with absences were not aware of their seizures. In 8 patients EEG findings demonstrated focal abnormalities which contributed to previous diagnostic errors. The described clinical and electrophysiological features met fully the diagnostic criteria of JME. In the Polish literature this is the first report on such a large groups of JME cases. Attention is called to diagnostic difficulties due to poor knowledge of this disease and its manifestations which leads to inaccurate history taking. Another cause is non-availability of full neurophysiological diagnostic facilities in many centers.

Adolescent↗

[Differential diagnosis in idiopathic generalized epilepsies with tonic-clonic seizures: assessment of the use of ambulatory EEG and video/EEG monitoring].

The value of long-term cassette EEG (24-EEG) and Video/EEG for differential diagnosis and classification of idiopathic epilepsies with generalised tonic-clonic seizures (GTCS) was evaluated in twenty-eight patients. The analysis of clinical and EEG features allowed proper classification of epileptic syndrome in twenty-two (79%) patients. In twelve cases absences or myoclonic seizures appeared beside GTCS after 1-9 years from epilepsy onset (mean 3.3 yrs). EEG and clinical data allowed to classify epilepsy in nine (75%) of those patients: in six patients as juvenile absence epilepsy and in three as juvenile myoclonic epilepsy. Sixteen patients suffered from GTCS only (mean duration of epilepsy 10.6 years); in thirteen of them (81%) the diagnosis of epilepsy with GTCS on awakening (AGM) could be established. 24-EEG and Video/EEG helped to demonstrate (a) interictal generalized spike/polyspike-wave discharges (SW/PSW) 3-6 Hz not present in routine EEG in 25% of patients, (b) typical circadian distribution of discharges in AGM patients and (c) absences and myoclonic seizures in 32% of patients. Slow spike-wave variants and focal changes in EEG which could suggest secondarily generalized GTCS were the main diagnostic problem.

Adolescent↗

[Post-stroke epilepsy].

The frequency of cerebrovascular aetiology of epilepsy is estimated at 3-30%, and the rate is significantly higher in studies carried out in developed world. Early seizures, variously defined by different authors (usually as those occurring within first week or first two weeks after stroke) occur in 2.5-6% of patients, in most of them within the first 24 hours after stroke. Early seizures constitute a major risk factor of poststroke epilepsy, but in many patients seizures do not recur after acute phase of stroke. The pathophysiology of poststroke seizures is not fully elucidated, probably it is different for early and late seizures. Several investigations evaluated the connection between seizures and localization of vascular foci, the results are not consistent; most investigators believe that seizures occur more frequently in cases of cortical localization of the focus. Seizures are more common in haemorrhagic than in ischaemic strokes. The most common type of seizures are simple partial seizures, the rarest are complex partial seizures. The prognostic value of EEG is of little importance: nevertheless, in poststroke patients who had at least one seizure, diffuse slowing of background activity or PLED are associated with increased risk of seizure recurrence. Early seizures do not require long-term antiepileptic treatment; late seizures usually well respond to treatment.

Anticonvulsants↗