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Biomedical subjects

C Groh

Publications and source records attributed to C Groh.

At least 19 recordsLinked to original sources
PubMed1996

Prognosis of childhood epilepsy in newly referred patients.

The aim of this study was to investigate the prognosis of childhood epilepsy and to analyze prognostic factors in addition to remission rate in a follow-up of newly referred patients. Two hundred eighty-one patients were followed for a mean period of 5.3 years. Overall, 253 patients (90%) achieved 1-year remission. The beginning of a 1-year seizure-free period was achieved in 77.9% by 1 year, in 84% by 2 years and in 88.6% by 3 years after onset of treatment. Early onset of seizures, symptomatic etiology, and neurologic handicap predicted a worse prognosis. In 44 of 253 children with complete suppression of seizures for 1 year, relapses occurred within the follow-up period. In one child with a relapse, remission could not be achieved in the 2nd year thereafter. In conclusion, our study shows a good prognosis for most children with epilepsy, especially in patients with idiopathic epilepsy and late onset of seizures and without neurologic dysfunction. Moreover, our data strongly suggest that the long-term pattern of seizure control is largely established during the first 2 years of treatment.

Adolescent↗
PubMed1990

[Function and structure of families with an epileptic child].

Although the impact of psycho-social factors on the individual patient with epilepsy has been widely investigated, the influence of the illness on the family as a whole is still underestimated. By means of the Family Assessment Measure (FAM III), a well-validated instrument, we investigated which measurable influence the epilepsy of one child had on the functioning of the families. Data from a group of 72 families with a child suffering from epilepsy (EG), but without any other handicap were analysed and compared with those of 75 families with a child with severe mental retardation (SMG) and 76 control families (CG). Data were gathered through home visits. Only complete families were studied. Results showed that the EG was similar to the SMG in all 3 scales of FAM III, but differed significantly from the CG. In 26% of the families in EG and in 19% of the SMG clear signs of family malfunctioning were found, as compared with 6.5% of the CG. Family disfunctioning in EG was of a greater variety that in SMG. We found that within the EG the type of seizures (41 patients with generalized tonic clonic fits, 10 with complex partial seizures and 21 with absences) did not have any impact on the results. In addition, neither the duration of the illness nor the absolute length of seizure-free periods seemed to matter. Only families who had the subjective feeling that their children were still suffering from epilepsy showed significantly higher rates of family malfunctioning. Summarizing, we found that epilepsy in a child can have a severe impact, not only on his individual life and on the mother-child relationship, but on the functioning of his family as the whole. This fact should be taken into account in the treatment of these children and should influence family counselling, as well.

Adaptation, Psychological↗
PubMed1990

[Computerized tomography in epilepsy in children].

We present a retrospective study of 160 children attending our epilepsy out-patient department. Computed tomography (CT) was performed on 123 (77%) patients, namely all children with the exception of those with febrile seizures, typical absence seizures, and benign Rolandic epilepsy. Incidence of CT abnormalities and their correlation with clinical features were evaluated. The CT scan was normal in 84 and abnormal in 39 patients. Although in general, the detection of abnormality on CT will not alter the management of the child, in a small percentage (2%) of our cases a lesion treatable by surgery was discovered. The indications for CT are summarized.

Anticonvulsants↗
PubMed1988

[Discrimination between epileptic and non-epileptic seizures using defined prolactin studies].

Prolactin blood levels (HPRL) increase within 20 minutes postictally after generalized epileptic, especially generalized tonic-clonic seizures and return to normal values within one hour. Elevated HPRL levels were also observed after complex partial seizures, but usually in less extent, exceeding normal ranges only slightly. Therefore baselin HPRL measurements are necessary for estimation of spontaneous fluctuations in comparison to changes after seizures. Unchanged PRL levels after attacks do not support their epileptic origin. Rage attacke showed no clear pattern of PRL changes.

Adolescent↗
PubMed1987

Psychogenic relapses in childhood epilepsy in puberty and adolescence.

Epileptic patients who, after years of being free from symptoms, have relapses during puberty or adolescence (some-times coinciding with a reduction in therapy) pose special therapeutic and diagnostic problems. Because of pubertal lability, the cause of a relapse might seem to be "organic", especially if the EEG also shows a "deterioration", yet psychogenic factors must not be disregarded. On the basis of typical case studies, a characteristic constellation is presented. The achievement of a "well-behaved" child at first dramatically improves and this correlates with the success of antiepileptic therapy. Then individuation and further development cannot adequately take place because the family unit is not functioning properly. At a critical stage of development, the excessive expectations of the parents lead to too much stress on the child, thus destroying the balance within the family system, which has hitherto been maintained only with difficulty. Attempts to improve the situation by changing the medication (increasing the dose or switching to another drug) fail. If, however, it is realized that the symptoms are of psychogenic origin, adequate therapeutic interventions (e.g. adequate schooling or professional training as well as psychotherapy) promise good results.

Adolescent↗
PubMed1987

Carbamazepine and benzodiazepines in combination--a possibility to improve the efficacy of treatment of patients with 'intractable' infantile spasms?

Therapeutical efforts in epilepsies with infantile spasms (IS) often show unsatisfying results, especially if neurological impairments are found. In a clearly negatively selected group of 24 children with IS and 10 patients with symptomatic myoclonic-astatic epilepsies--pretreated without success with ACTH and/or benzodiazepines (BDZ) alone or combined with other anticonvulsants--we tried a two-drug therapy of BDZ with carbamazepine (CBZ). Dosage of both drugs was within the usual range. In a follow-up period of 1-5 years, 8 of the IS patients and 4 of those with myoclonic-astatic seizures became seizure-free; furthermore, 6 children showed a marked reduction in their seizure frequency: 3 more than 80%, 3 more than 50%. Besides the fact that the patients did not develop a so-called escape-phenomenon--as often seen in therapy with benzodiazepines--they also showed fewer and less intensive side-effects. Without optioning for antiepileptic polytherapy in general, we conclude that in cases of "intractable" IS the combination of BDZ with CBZ might be more successful than the single drug. To confirm these preliminary findings further controlled studies have to be carried out.

Carbamazepine↗
PubMed1984

[Psychosocial dwarfism--a rare form of growth disorder].

Psychosocial dwarfism is a syndrome caused by emotional deprivation (maternal deprivation), characterized by symptoms of delayed motor and intellectual development, abnormal eating and drinking habits, enuresis and encopresis, aggressiveness and a pathological family structure. Diagnosis of psychosocial dwarfism is easy if the case history is carefully elicited and the growth hormone level is determined within the first few days following change in environment (e.g. hospitalization). Difficulty in reaching the correct diagnosis or misdiagnosis can occur if the symptomatology is not studied in its entirety. Diagnosis at the earliest possible stage is very important for the further development of the child, since behavioural disturbances and growth retardation are reversible with environmental change. This is demonstrated by the presentation of the case history of a 6 year-old boy--the third case reported in the German literature.

Child↗
PubMed1984

[Conversations with parents of children with seizures].

When treating children with seizures, repeated and extensive talks with parents and child are an integrating part of diagnosis and therapy. The form of the conversation depends on its topic and the timing. From the physician's point of view, there are 3 forms of such conversations. 1. Informative, 2. counselling, 3. therapeutic. The subjects are in particular 1. getting the anamnestic data, 2. breaking the diagnosis to the parents and discussing the prognosis, 3. helping them in their confrontation with the "fate" of their child having epilepsy, 4. discussing special pedagogical and psycho-social problems. This kind of talk ranges from preventing faulty educational attitudes to intervening therapeutically within the patient's family.

Adult↗
PubMed1983

[Threatened occupational situation of parents as a pathogenetic factor in childhood behavior disorders].

Real or imminent loss of employment of family supporters (mostly fathers)--unfortunately nowadays a rather frequent event--has gained more and more importance with respect to genesis of child's behavioral disturbances. Different interaction patterns are listed here: family systems primarily regarded as free of conflicts can be desequilibrated by financial distress; especially by loss of self-value-feelings; by appearance of different child rearing methods. Sometimes the tolerance for already striking children decreases, resulting in decompensation.

Adolescent↗
PubMed1982

[Psychopharmacological drugs in childhood (author's transl)].

The use of psychopharmacological drugs on children is still widely disputed. A questionnaire sent to Austrian pediatricians should give a realistic picture of the individual doctor's opinion to this question. The results are compared with reports in literature and the experience gained from patients in the medical pedagogical department of the University Children's Hospital, Vienna. A plan of treatment which has proved efficacious in hospitals is presented.

Aggression↗
PubMed1981

[Treatment result and treatment resistance in early childhood petit mal epilepsy].

The data of 115 children with age-dependent epilepsy in early childhood and treated in the out-patient department of the university clinic for pediatrics in Vienna in the past 20 years were prepared for computerization and subsequently processed. The average observation period was 10,9 years (SD = 6,81 years). At the time of the study 20 out of 35 children with infantile spasms and 61 out of 80 children with myoclonic-astatic seizures were free from seizures. We consider Benzidiazepines to be the optimum treatment for both of the above-mentioned kinds of seizures. If they failed to achieve the desired success, ACTH and steroids proved to be quite effective. In cases of myoclonicastatic seizures with generalized EEG patterns, VPA is indicated. In order to be able to judge the dynamics in psychic development more effectively, we divided our patients into three groups: children with stable development, those with obvious retardation, and those with obvious positive development in the course of therapy. There was no statistically significant correlation between a delayed onset of therapy and the absence of seizures as well as a more satisfactory psychic development (according to the Man-Whitney-Test and the Kruskal-Wallis-Test). In children with infantile spasms we found a statistically significant correlation (p less than 0.05) between relief from seizures and a satisfactory psychic development. In general, the somatic and psychic prognosis of Petit-Mal epilepsies in early childhood seems to depend on pretherapeutical factors.

Anticonvulsants↗
PubMed1980

Is the therapy with carbamazepine more effective when measuring blood levels?

41 patients receiving Carbamazepine under regular measurements of blood levels were compared with 77 patients with no or irregular controls of the blood level. 71% of the patients in the first group had a good seizure control in contrast to 61% of the patients in the second group. Furthermore, patients with regular controls reached the desired therapeutical effect earlier (on an average within 21/2 months) compared with patients with no or irregular controls (the average was 10 months). Patients who did nor react to medication with CBZ were put on another drug within a shorter time if their blood levels were measured (on the average 10 months compared with 20 months). We conclude that regular blood level controls make handling of CBZ easier. This allowed us to extend the range of indications for CBZ to a greater number to epilepsy with grand mal and focal seizures as well as to few therapy-resistant cases of epilepsy of early childhood with tonic seizures.

Carbamazepine↗
PubMed1980

Visual perception disabilities in epileptic children at the beginning of schooling.

Even among normally intelligent epileptic children learning difficulties occur with relative frequency. It seemed plausible to assume that visual perception problems play an important role. We decided, therefore, to analyse the quantity and quality of such disabilities. 42 epileptic children between 5 and 8 years of age, all capable of attending school, were tested with M. Frostig's Developmental Test of Visual Perception. The results can be summarized as follows: 1. The average perceptual quotient fell below the normal range. 2. There were significant differences in perceptual ability between children with primary generalized epilepsy and those with generalized secondary or partial epilepsy, to the disadvantage of the latter group. 3. In particular the Scaled Score of Subtest II measuring figure ground perception proved to be a sensitive criterion. The Subtest is therefore recommended as a screening method to uncover visual perception deficiencies in epileptic children prior to the beginning of schooling.

Child↗
PubMed1979

[Determination of antiepileptic drug levels in the blood: day-to-day experience in an out-patient clinic for epilepic children (author's transl)].

The possibility of determining the blood levels of antiepileptic drugs represents a considerable advance, under certain circumstances, objective supervision of anticonvulsant therapy. In particular in the case of an unsatisfactory therapeutic result, this procedure helps to reveal the causes of failure (e.g. incorrect administration, poor absorption, interaction with other drugs). Like many new diagnostic methods this method is rather costly; hence, its use within the daily routine work should be limited to definite indications. Apart from its use in cases of inadequate control of epilepsy and the appearance of side effects, other indications for implementation of the method are the establishement of correct dosation of antiepileptic drugs in new patients and drug intercurrent illness, which frequently necessitates the use of additional drugs.

Anticonvulsants↗