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Biomedical subjects

H Fichsel

Publications and source records attributed to H Fichsel.

At least 19 recordsLinked to original sources
PubMed1985

[Familial episodic ataxia].

5 members of a family with periodic cerebellar dysfunctions are described. This rare disorder occurred in the early childhood and is characterised by episodes lasting minutes to hours with severe cerebellar ataxia, dysarthria, diplopie, nystagmus, vertigo and vegetative symptoms. The examinations between attacks are almost normal. The inheritance appears to be autosomal dominant. An atrophy of the cerebellar vermis was found in two patients. Syndrome and investigation results were compared to the seven papers according this disorder, which were published until now.

Adult↗
PubMed1985

Longterm follow-up of childhood epilepsy with absences. I. Epilepsy with absences at onset.

The purpose of the follow-up study was to determine whether modern therapy with ethosuximide and/or valproate with/without phenobarbitone and its derivatives improves the longterm prognosis of absence epilepsy as compared to formerly used treatments. The patient population consisted of 194 cases (88 boys, 106 girls) with spike wave epilepsy starting with absences. In each case the diagnosis was confirmed by clinical observation and the typical EEG pattern. Only those patients were included who could be followed beyond the eighteenth year of life (up to age 45). The sample includes also older patients diagnosed during the fifties, before the present standard therapy was available. Because of the heterogeneity of the material and its selection, the data obtained are not suited to make a general statement about the ultimate prognosis of absences. The results demonstrate the effectiveness of regularly applied modern treatment. 72 out of 194 patients (37%) manifested generalized tonic clonic seizures (gtcs) during the course: 20 of these patients showed only incidental generalized tonic clonic seizures, which were not dependent on therapy. In 52 cases gtcs appeared without relation to precipitating factors. None of these patients received regular standard therapy before onset of gtcs. In 31 cases absence statuses were observed. These patients did not have an unfavourable outcome provided the standard therapy was instituted early and consequently. A change from absence epilepsy into an epilepsy with complex partial seizures sensu strictiori could not be observed. At final investigation 42 of 194 patients still had seizures: 7 with absences, 35 with grand mal with or without absences.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1985

Longterm follow-up of childhood epilepsy with absences. II. Absence-epilepsy with initial grand mal.

The study deals with 83 patients with absence epilepsy which had started with generalized tonic clonic seizures. Only those patients were included, who could be followed up to an age older than eighteen years. The patient population is heterogeneous; it includes numerous older patients in whom therapy had been instituted at a time when the present standard medication with ethosuximide and valproate was not available. Therefore the data cannot be used as a basis for global statements concerning the prognosis of absence epilepsy with grand mal onset. About 80% of the patients treated with standard therapy became seizure free. An unfavourable course was mainly preceded by incorrect, irregular and quantitatively inadequate therapy. Standard therapy cannot prevent singular generalised tonic clonic seizures in the late course. The social status of adult patients is mainly favourable if they are seizure free. Sporadic attacks usually will not impair social integration. In all, absence epilepsy starting with grand mal responds not as well to therapy and has a more unfavourable social prognosis than epilepsy starting with absences.

Adolescent↗
PubMed1977

[Changes in the thyroid hormone system with combined anticonvulsion treatment of epileptic children and adolescents (author's transl)].

Anticovulsant combined treatment produces statistically significant reduction of total thyroxine, free thyroxine and protein-bound iodine. Total cholesterin is significantly raised on average of the total. Basal concentration of thyreotropic hormone is slightly lowered. The extent of changes is rather greater than with Valproat-, Diphenylhydantoin- and primidon permanent treatment; it corresponds with that seen in long term Carbamazepin treatment. No definite combinations of anticonvulsants could be found which would act in a particularly unfavorable fashion on the thyroid hormone system. In double combinations the changes in serum concentrations were the same as in triple combinations. The action of combined treatment in permanent treatment with single drugs is thought to be due to a removal of T4 from the transport protein link and induction of liver enzyme, which produces rapid conversion and metabolizing of T4. A hypothalamic action of combined antoconvulsants is discussed.

Adolescent↗
PubMed1977

[The effect of primidone treatment of thyroid hormones in epileptic children and adolescents (author's transl)].

In primidon-treated patients there are significantly decreased serum concentrations of total and free thyroxin, protein bound iodine and base line serum TSH values. In primidon-treated children T3-resin test values, concentration of thyroxin-binding protein and total cholesterol are identical to those of the control group. Degree of diminution in serum concentration of protein bound iodine, total and free thyroxin and base line TSH was independant of the primidon dose per day. Probably the demonstrated alteration in the thyroid function tests studied, is mainly caused by phenobarbital, the major metabolite of primidon and not directly by unmetabolized primidon. It is suggested that the high protein-binding capacity of phenobarbital results in a competitive displacement of protein bound thyroxin comparable to that of DPH. Phenobarbital is know to be a stimulator of the drug metabolizing enzyme system in the liver. This effect may be the cause of an increased turnover of T4 which results in a decreased serum concentration of total and free T4 at last. It seems possible that there is a balance in serum concentration of thyroid hormones on a lower level. Normal euthyroid state may be presumed, if T4-secretion raises, but there is no clue for an increased pituarity response. In contrast to the normal group in primidon-treated children the base line serum TSH values are decreased. It is supposed that another effect of primidon is responsible for this fact. There may be an influence of primidon treatment on hypothalamic pituarity axis. Our findings do not indicate clearly a hypothyroid state in primidon-treated patients; further investigations should give an answer to the guestion, if side effects as tiredness, decreased impetus and constipation are not partly caused by alterations in thyroid hormone system.

Adolescent↗
PubMed1976

[Diagnosis of hydrocephalus. Changes in visual evoked potentials in children with progressive hydrocephalus internus].

Visual evoked potentials (VEP) of 12 children with progressive hydrocephalus internus were studied. Depending on the severity of hydrocephalus internus VEP show remarkable changes. First of deformation of VEP occurs, than a slowing of latencies and finally an extreme increase of latencies combined with a further deformation of VEP. The whole duration of the VEP shows a marked prolongation.

Evoked Potentials↗
PubMed1976

[The influence on the thyroid hormone system by long-term anticonvulsive therapy with valproat (author's transl)].

Valproat lowers the serum concentraiton of PBI and T4 in epileptic children. Since this reduction is not so pronounced with PBI as with T4, the difference in comparison with the controls could not be statistically verified with the desired probability of error. The reduction of general thyroxine can be statistically verified when compared with healthy control individuals. Free thyroxine is not influenced by Valproat therapy. The TBG TSH and the T3 in vitro test do not indicate variations from the healthy control subjects. The same is true for serum cholesterol. Valproat does not cause hypothyroidism; the reduction in PBI values and T4 serum concentration must be explained by competative displacement out of the protein bonds by Valproat.

Acetates↗
PubMed1976

[Influencing of the thyroid hormone system by long-term treatment with 5-5 diphenylhydantion in children and adolescens (author's transl)].

In the context of anticonvulsive maintenance therapy in epileptic children and adolescents, 5-5-diphenylhydantoin leads to a statistically significant decrease in total thyroxin (T4), protein-bound iodine (PBJ) and free thyroxin (FT4). The consequences of DPH therapy are based on the direct and indirect influence of DPH on the thyroid hormone system. DPH competitively pushes the T4 out of its plasma-protein bond. The lowering of T4, PBJ and finally also FT4 can be traced back to an indirect influence of DPH which consists of an increase in T4 metabolism in the liver by the DPH-induced enzyme. The possibility of a direct effect of DPH on the hypothalamus was discussed.

Adolescent↗