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Péter Rajna

Publications and source records attributed to Péter Rajna.

7 recordsLinked to original sources

[Efficacy, safety and effect on the quality of life of gabapentin in adult epilepsy--results of a prospective open-label quasi naturalistic Hungarian multicenter study (phase human-IV)].

PURPOSE: To evaluate the efficacy and safety of gabapentin (GBP) in idiopathic or crypto/symptomatic partial epilepsy in adults. METHODS: We performed a prospective open label add-on study in pharmacoresistant patients with simple or complex partial or generalized seizures of partial onset (at least four seizures per month). GBP was added to no more than two baseline antiepileptics and the efficacy was rated primarily according to the seizure frequency. The secondary efficacy parameters were the change in the seizure severity scores (measured by the NHS3 scale) and in the quality of life (measured by the QUOLIE-31 questionnaire). GBP was added up to 1500-1600 mg per day in the titration period than an individual optimalization was allowed in any further visits. The follow-up period was three months. POPULATION: Fourteen Hungarian epilepsy out-patient unit participated in the study. 72 patients were enrolled, GBP was applied in 63 persons (ITT population) and 57 completed the study. RESULTS: A more than 50% decrease in seizure frequency was found in more than 70% of the patients in the third month. Among them just every third patient became seizure-free. Significant improvement appeared also in the severity of seizures and in the total score of the quality of life questionnaire. There was no difference either according to the etiology of the epilepsy or the seizure types. GBP was tolerated excellently. There was no need to decrease of the dosage of GBP and the side effects were mild and of transitory nature. CONSEQUENCES: GBP appears to be a valuable antiepileptic drug considering its high efficacy and extremely favourable tolerance. While GBP also decreases the severity of the seizures, its complex effects result an improvement in the quality of life of the patients. The positive effects have been durable during the follow-up. Open label naturalistic studies of larger population are needed to clear the special indications of GBP in chronic partial epilepsies.

Adult↗

[Event-related EEG and evoked potential investigations in clinical practice].

Considering the limits of the traditional EEG techniques the authors review the main methods and clinical importance of the event-related EEG investigations. According to methods, these can be classified into the spectral analysis of task-related, pre-task and post-task recordings as well as stimulus-controlled measurements based on evoked potential techniques. The main results of clinical studies on the event-related EEG methods are summarized according to chief disease groups (Alzheimer's disease, epilepsy, schizophrenia, Parkinson's disease, dyslexia, depression). The authors discuss the stimulus-dependent EEG discharges (P300, cognitive potential) in detail. They present the meta-analysis of 224 recent publications on human application of these methods. They analyze the involved scientific areas and the frequency by which these methods were applied in each. Following this, the results of 83 selected clinical studies are summarized. The frequency of the application of the various event-related EEG methods and the tested wave components and other parameters are listed. Finally a summary of the main clinical results is presented again by groups of diseases (schizophrenia, behavioral disorders, traumatic lesions, enuresis nocturna, depression, memory disturbance and dementia, drug effect). Finally, the potential perspectives and the limitations of the event-related EEG methods are briefly discussed.

Alzheimer Disease↗

[Psychosocial conditions of adult epileptic patients in Hungary].

Authors analyze the possible connections among psychosocial, more important epileptological and social conditions in the population of the Hungarian Epilepsy Database. The inclusion criteria were the presence of repeated epileptic seizures, the strict diagnosis of epilepsy and at least three registered control visits. Four hundred and fifty 30 or more years old patients fulfilled the criteria. Based on the answers to four questions in the database considering some conditions potentially modifying the way of life the patients were scored and distributed into 3 subgroups (good, average and bad) concerning their psychosocial conditions. In contrast to previous expectations they found that the type of epilepsy does not influence the attainable psychosocial conditions. Presence of generalized tonic-clonic or complex partial seizure did not exhibit influence either. Analysis of the seizure frequency showed that generalized convulsions, if occurred rarely were accompanied by good psychosocial level and if occurred frequently they were accompanied by a less acceptable level. Psychopathological symptoms independently from their nature and evidenced brain lesion as etiology also made the psychosocial conditions worse. No difference was found concerning the gender of the population. It contradicts the hypothesis that epilepsy has a greater impact on females. Psychosocial conditions are better in patients with higher education and living in pairs. Based on the study authors support the statements of the literature emphasizing that for achieving the best quality of life and psychosocial level an appropriate medical care is not enough. They need also the relative highest level of education and a stable partnership.

Adult↗

Car drivers with epilepsy (Pilot Hungarian EPIMED Database Evaluation).

We investigated aspects of driving among Hungarian patients with epilepsy. Nineteen percent (148/753) of our population had a driving license (DL), including 26% (38/148) who used it. Among persons without a DL, 29% (178/605) desired one. Among those who drove (n=38), 24 worked and 8 had experienced seizures in the last 3 months. Each of these seizures occurred during sleep (5/8), were preceded by known auras and warning signs (2/8) or were provoked by extreme external factors (1/8).

Adult↗

[Utility of electroshock therapy in epilepsy-associated psychosis].

Psychiatric disorders which indicate the use of electroconvulsive therapy (ECT) also occur in epileptic patients, but there is a lack of medical authority concerning the use of ECT in epileptic patients. This is surprising because in recent years it has been proved that ECT has an anti-convulsive effect to some degree. A case study of an epileptic patient is presented whose progress has been monitored for several years. Antiepileptic drugs were seemingly able to control his epilepsy but at the same time progressive behavioural disturbance (schizophreniform psychosis) accompanied by agitation and violent behaviour developed. Considering the recurrent psychotic decompensations and the relative ineffectiveness of antipsychotics, the authors decided to administer ECT. As a result they were able to bring about the longest symptom free balanced period in the patient. According to the data based on previous medical studies and the experience they can suppose that ECT is not immediately contraindicated by the presence of epilepsy with active interictal focus if the psychopathological condition makes it necessary. In view of the epileptogenic risk factors of classical neuroleptics, the epileptogenic effects of accompanying psychosis and the probable anticonvulsive potential of ECT in cases of severe psychiatric complications accompanying epilepsy ECT could be used more frequently.

Adolescent↗

Anxiety in epilepsy--based on two case reports.

There are a great number of psychopathological symptoms which manifest themselves in 70-75% of epileptic patients but most of them remain unrecognised and untreated. These symptoms may affect the patients' quality of life more negatively than the epileptic seizures themselves. Anxiety is one of the most frequently occurring interictal psychopathological symptom. A number of specialists agree that chronic epilepsy causes the amplification of endogenic seizure suppressing mechanisms which hinder the epileptic seizures and are responsible for the development of interictal psychopathological symptoms. However the physiological effects of the interictal psychopathological conditions (e.g. anxiety) have epileptogenic effect as well. There is a high chance that the conditions of epilepsy and anxiety will mutually create a destructive vicious circle and it will be illustrated by our two case reports. In our experience, before modifying the pharmacotherapy of a patient suffering from chronic epilepsy with increased frequency of seizures, the anxiety level should be defined; and if it is high it should be treated first. From our perspective, the so-called "rational bitherapy" is very effective when a high potential antiepileptic drug is combined with an anxiety reducing method. The latter can be drug related or consists only of psychotherapy. We need more controlled clinical research to prove that inside epilepsy there are risk groups as well as conditions of high risk when the connection between anxiety and epilepsy is more than evident. The described cases seem to indicate that the existence of periictal anxiety can be a risk factor in developing later interictal anxiety.

Adult↗