[Role of orthopedic surgical treatment in prognosis concerning children suffering from cerebral palsy].
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Biomedical subjects
Publications and source records attributed to C Buksowicz.
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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 In the group of 33 patients 39 could complete the treatment, one patient died suddenly, three had the treatment withdrawn in view of side effects.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.
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.
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.
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