[Requirements for starting epilepsy therapy].
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Biomedical subjects
Publications and source records attributed to R Cammann.
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The latency and amplitude data of optically evoked potentials (unipolar from the vertex) were measured during the 50-200 ms interval in a group of normal boys (n = 26) and a group of boys with brain damage sustained during early childhood (n = 38). The latency periods were sometimes significantly longer and the amplitudes larger (flash stimulus) and smaller (pattern stimulus) respectively in the brain damaged than in the normal subjects. In view of the results of clinical, neurological and psychological examinations, these phenomena must be attributed to delayed maturation of the central nervous functional system.
The testing of Convulsofin carried out in 220 patients at 14 clinics over a period of six months confirms the international experience gained with valproic acid and sodium valproinate. The main field of application of Convulsofin according to the experience gained will again be the treatment of fits in generalised primary epilepsy for which it permits to carry out a monotherapy to a remarkable extent. The favourable effect of the preparation in photosensitivity could be confirmed. Also in generalised secondary epilepsy and in fits of partial epilepsy. Convulsofin is partly effective, so that it can recommended as a co-medication in the treatment of therapy-resistant forms of these epilepsies which are difficult to treat. Decrease in thrombocytes, transient increase in serum transaminases, gastrointestinal disorders, loss of hair and undesired increases in body-weight were the more frequently occurring side-effects.
In 21 boys with normal brains and 34 boys who had sustained brain lesions during early childhood the time course of habituation of the vertex response was studied. All boys showed normal intelligence and were aged between 9 and 11. Boys were tested under different experimental conditions using periodic and aperiodic flash-stimuli at constant intensities (1.2 J). The peak-to-peak amplitudes of the prominent N1-P1 and P1-N2 component were measured. A gradual decrease of the amplitude was observed as a function of the stimulus program and the duration of the experiment. A significant, more rapid habituation was observed in boys with early brain damage. These results suggest that the capacity of tonic activation is disturbed in children with brain-organically impaired performance.
Berger effect behavior was tested in a group of 15 boys with early brain damage and a control group of 15 boys without an anamnesis of brain damage, with a view to development, conditioning ability and habituation. In the group of brain-damaged test persons the proportion of BE-positive subjects was markedly less in all trials. Habituation occurred earlier and in a larger percentage. The conditioning capacity was worse in each series. The phenomena observed suggest that subjects with early brain damage suffer from a disturbance in the general reticular action system.
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The symptomatology of phenytoin intoxication was observed in 8.4% of 225 adult patients and in 9.5% of 74 children, with symptoms of cerebellar affection being noted in the majority of cases. Phenytoin concentrations were found to lie between 14.4 and 77.7 microgram/ml. Interindividual differences as to the toxic limit were quite considerable: One third of the patients showing values higher than 20 microgram/ml were free of striking clinical symptoms, and one patient tolerated a serum concentration in excess of 30 microgram/ml. On the other hand, the intraindividual toxic limit did not show any major variations: The clinical symptomatology of a patient correlated with his phenytoin serum concentration. After phenytoin withdrawal, the serum concentration dropped exponentially. The half-life periods of elimination were found to be between 72 and 122 hours.
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1. The behavior of the occipital alpha rhythm during open-eye derivation was studied on nine- to twelve-year-old boys of normal intelligence, of whom ten were free from brain injuries and eleven had been suffering from brain injuries in early childhood. 2. There was observed a marked tendency of the alpha index to differ in dependence upon the time of testing, the cause of which was believed to be a weakness of vigilance on the part of brain-injured children. 3. Application of this simple method of examination to group comparisons makes it possible to neurophysiologically determine an important part of chronic cerebropsychic axis syndromes.
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Telemetry is the transmission of the test data of moving object, with a distinction being made between wireless and wire-connected telemetry. The applicability of this technique is examined on the basis of experience gained, and data gathered from books and articles on the subject. Biotelemetry constitutes a new development in technology and methodology which, if critically applied in meeting the various challenges confronting the specialist, can render useful service in the field of electroencephalography.
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