[A social therapeutic unit in a district hospital. Aims, organization, experiences].
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Biomedical subjects
Publications and source records attributed to L W Diehl.
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There are no personality structures which are typical of epilepsies in the sense of a change in character that can be seen in cross and especially in longitudinal sections. Reported changes of character due to epilepsies cannot be exactly defined reproducibly for the forms of fits to be differentiated and cannot, therefore, be used operationally. There is no doubt, however, that several causal factors must be considered to be responsible for the manifestation of certain frequently observed peculiarities and characteristics, respectively. In addition to organic, psychodynamic, and socio-situational causes, long-time antiepileptic medication is an essential factor of changes in character due to diseases characterized by fits. A better understanding has now been obtained of the importance of this particular factor, and this allows to conclude that there can only be epileptic functioning and reacting.
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As more recent investigations have shown, many women regularly take drugs not prescribed by the doctor during pregnancy, in addition to those that are. It is not always a matter of diseases which require treatment. It is shown, with reference to a number of patients, that unproblematic longterm anticonvulsant therapy - with years practically free from attack - can be complicated by pregnancy. During an essential treatment with multiple drugs made necessary by the pregnancy, 6 attacks of grand mal were recorded in 6 months and sometimes very low serum DPH concentrations were found in spite of reliable, high doses of Zentropil.
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4 patients with therapy-resistant psychomotor seizures had been treated with high doses of carbamazepine for 3-6 mo. The serum concentration, taken 2-hourly from 1600-0400 and at 0700 hr, showed the plasma half-life to be on the order of 10 hr, about one-third of that in normal volunteers. The half-life was about 5, 10, 10 and 20 hr. The findings showed that a therapeutic concentration of carbamazepine in serum can be maintained over 24 hr by 3 high doses per day. Single doses of up to 800 mg could be taken without serious side effects in patients treated for long periods with carbamazepine as sole medication.
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