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Biomedical subjects

R Degen

Publications and source records attributed to R Degen.

At least 37 records · Page 2Linked to original sources
PubMed1983

[Sleep EEG in patients with myoclonic-astatic seizures (Lennox-Gastaut syndrome)].

Short term sleep-EEGs of children (23 males and 7 females) with myoclonic-astatic seizures were carried out. All of them were treated with mostly more than one antiepileptic drug. An EEG during wakefulness was recorded shortly before sleep in 23 patients, whereas 7 children fell asleep at once. Sleep was induced with 2 mg/kg body weight Protactyl syrus (promazie hydrochloride). The clinical findings correspond with known results. In the wake EEG epileptic activity was recorded in 16 out of 23 cases. In the sleep EEG epileptic discharges were seen in all patients with the exception of 2, who were free of seizures. These discharges were most frequently recorded in stage B (25 times) 20 times in stage C, 18 times in stage A und 13 times in stage D. The REM-stage was never reached. Also in respect of the total duration of the recording considerably more epileptic activity was seen in the sleep EEG (29%) than in the wake EEG (16%). In 3 cases more epileptic activity was found in the wake EEG. In the 5 patients showing no epileptic discharges in the wake EEG only little epileptic activity (2.06% of the total recording time) was seen in the sleep EEG. In sleep, single epileptic paroxysm and series of epileptic discharges with and without multiple spikes as well as continuous epileptic activity with multiple spikes were more often recorded. Likewise stretches of continuous generalized spikes were more frequently seen--in 9 patients--during sleep as opposed to 2 patients in the waking state. They represent--mostly at night--subclinical or clinical tonic seizures.

Adolescent↗
PubMed1981

A comparative study of the diagnosis value of drug-induced sleep EEGs and sleep EEGs following sleep deprivation in patients with complex partial seizures.

The purpose of the study was to investigate whether the sleep EEG after sleep deprivation has a stronger provocative effect than the drug-induced sleep EEG. For this purpose a sleep EEG, induced by 2 mg/kg body weight of promazine hydrochloride, was recorded. On the following day a sleep EEG of the same patient was recorded after sleep deprivation of 24--26 h. If only patients whose wake EEGs were free from epileptic activity are considered, the rate of provocation was 58%. As epileptic activity could be recorded even in the sleep EEG without sleep deprivation in 45%, the advantage gained by recording a sleep EEG after sleep deprivation (52%) is only relatively small. The occurrence of epileptic activity was shown to be significantly more frequent amongst women and those who developed epilepsy at a younger age. For practical purposes it is recommended that for those patients whose wake EEGs are free from epileptic activity, a sleep EEG--possibly drug-induced--should be recorded. Only in instances where epileptic activity can not then be recorded should a wake EEG after sleep deprivation be carried out, and followed immediately, if necessary, by a sleep EEG.

Adolescent↗
PubMed1980

[Hemiplegic migraine in childhood (author's transl)].

The first attack of hemiplegic migraine occurred in most cases between the 10th and 15th year of life in 14 children (8 boys and 6 girls). Most attacks took place with intervals of 3-6 and 6-12 months. Only rarely did they last longer than 24 hours. Precipitating factors (emotional and physical stress, change of weather, influence of light or heat) were given in 6 cases. As many as 7 children attended higher schools with good or average success. A family history, mainly from the maternal side, existed in 11 cases. Sensory symptoms were demonstrable in all children, motor symptoms in 9 and visual symptoms in 13. Ten children had speech disturbances. Hand, lower arm, cheek and tongue were most frequently involved in sensory and motor symptoms. Out of 9 attacks registered with an EEG severe focal signs (delta or theta-delta foci) were demonstrable contralaterally in all children, in 8 children there were also signs of generalized disturbances.

Adolescent↗
PubMed1980

A study of the diagnostic value of waking and sleep EEGs after sleep deprivation in epileptic patients on anticonvulsive therapy.

One hundred and twenty-seven waking and sleep EEGs were recorded from 102 epileptic patients on anticonvulsant therapy, after sleep deprivation. Epileptiform activity was found in 63% of the patients, or 57% of the records. Since in previously recorded waking EEGs epileptic discharges had been registered in 19%, or 17% respectively, the rate of increase was considerable. The rate of activation was 51% in patients without epileptic activity in their waking EEGS. Two-thirds of the epileptiform activity were already recorded in the waking EEGS, after sleep deprivation, One-third was recorded only during sleep. Epileptic discharges in the different sleep stages ranged from 25% (E) to 48% (C). On the other hand, approximately the same frequency was recorded in the separate sleep stages in patients whose waking EEGS after sleep deprivation showed epileptiform activity. The EEG changes were correlated with the different clinical parameters (type of seizure, frequency and duration of seizures, age at the first seizure and the time of examination, neurological findings, and personality changes).

Adolescent↗
PubMed1980

[Diagnostic significance of sleep EEGs in children with febrile convulsions].

The sleep EEGs of 52 children suffering from febrile seizures were recorded. Their waking EEGs were free of epileptic activity. Only a few patients fell asleep without medication, the majority received 2 mg/kg body weight of promazine hydrochloride. Epileptic activity occurred in the sleep EEG of 15 out of 52 patients (29%). Exclusively short generalized paroxysms of high amplitude, mostly irregular and partially abortive 3-4/sec spike-wave complexes and occasional 2.5/sec sharp-slow-wave complexes were recorded. Epileptic discharges were detected in the B stage in 11 patients, in the C stage in 10 patients, in the A stage in 7 patients and in the stage D in two patients. They were recorded more often in cases where more than one seizure had occurred, and where the patients were more than two years of age. Generalized spikes and waves were also seen most frequently in the case of so-called complicated febrile convulsions. Although there were differences in the cases of females, in incidences of a family history of seizures and delayed toilet training, these were not statistical significant. Likewise, a complicated pregnancy and birth as well as a delayed stato-motoric development showed no correlation. These results together with other findings justify the conclusion, that the majority of febrile convulsions should be classified amongst the primary generalized epilepsies.

Age Factors↗
PubMed1980

[The EEG during the hemiplegic migraine attack of children].

Following the exemplification of the clinical symptoms the EEG findings of 10 attacks of hemiplegic migraine in 6 children are reported on. Characteristically most of these are severe unilateral or focal disturbances. Five times these appeared as delta-activity, two times as theta-delta-activity, and in one case as theta-activity or alpha-reduction. Only once, a diffuse slowing of the background-activity over both hemispheres could be shown. With one exception in addition to the foci simultaneous diffuse changes were recorded in all children, (four times slight, twice slight to moderate and three times moderate to severe). A predominance of one hemisphere was not recognizable. The foci were not localized to one particular region of the brain. Most of the changes had subsided after a few days. In one case a slight focal voltage depression was apparent even after three month of a year.

Adolescent↗
PubMed1978

Epilepsy in children. An etiological study based on their obstetrical records.

Events which might have a casual significance for epilepsy were collected from the obstetrical case reports of 100 epileptic children who were born in four hospitals in a large town. 100 healthy children of the same age, who had been born in the same hospitals, served as a control group. The differences were worked out by means of the Chi square test and where small numbers were involved the Yates theory was used. It indicated that some possibilities of damage (e.g. higher age of the mother at birth, toxemia of pregnancy, premature birth, heavy weight at birth) are important either with respect to all patients or to the different types of attacks, whereas other factors (e.g. abnormal positions, instrumental delivery, coiling of the umbilical cord) whose roles are likewise never usually doubted, can be neglected. Exogenous reactions were found most frequently in the case of patients with grand mal and focal attacks, although, as was expected, they were missing in patients with absences, whose main genetic nature is known. It is pointed out that only with extreme caution may the various possibilities of damage be found responsible for epilepsy in children in general or for the individual types of attacks.

Adult↗
PubMed1978

[The etiology of epilepsies in children by considering the case histories in comparison with a control group (author's transl)].

To clarify the etiology of epileptic illnesses in children a detailed questionnaire was prepared, with questions on both genetic factors and the possibility of pre-, peri- and postnatal injury. The questionnaire was filled out by the parents of 422 epileptic children and those of 150 healthy control children of the same age. The differences were statistically calculated by means of the x2 test, small values being corrected according to Yates. Hereditary factors were found in 10.2% of all patients, ranging from 5.6% to 13.5% for the various seizure types (control group:0.6%). A high rate of hereditary afflictions was found even in those types of seizure which are considered predominantly symptomatic (salaam [West] or myoclonic-astatic convulsions: 13.5%, focal attacks: 11.2%). The significance of some exogenic factors, e.g. illnesses during pregnancy, prematurity, birth complications, was statistically confirmed in some instances for all types, in other instances only for certain types of seizure. As regards other factors, however, whose causative role has hitherto been considered proven or at least very probable, no differences were found between patients and controls (e.g. protracted labor, uterine inertia, coiling of the umbilical cord). Confirmation was found for the generally accepted rule that exogenic injuries are most often demonstrable in children with salaam or myoclonic-astatic convulsions and least often in those with absences. In conclusion, it is emphasized that an absolute dividing line can no longer be drawn between genetic and symptomatic epilepsies; in many cases the exogenic influence merely serves as a touching-off factor for a gentic epilepsy.

Adolescent↗
PubMed1975

[The valence of genetics and exogenous factors in epilepsies of childhood (author's transl)].

Exogenous and genetic factors must be taken into consideration in the etiology of epilepsy. Exogenous lesions may arise pre-, peri- or postnatally. The effect of genetics on the etiology has previously been suggested by a markedly increased familial occurrence of epileptic patients with seizures, investigations of twins and the occurrence of attacks in demyelinating diseases and congenital metabolic disorders. A modern method of examination in epileptic patients is the electroencephalographic family investigation. The results obtained in examinations by this method are described.

Adolescent↗
PubMed1975

[The epileptic child and his environment (author's transl)].

The discovery of electroencephalography and the development of modern anticonvulsants have made it possible to improve substantially the diagnosis and treatment of the epileptic attack. Resistance to treatment and multiple lesions of some of the patients, however, still give rise to considerable problems. Also an unjustified resentment of the environment still produces additional difficulties for the epileptic child. The position of the epileptic within the family, in hospital, in school and at work is discussed in detail. Besides diagnostic and therapeutic measures, additional medical help to overcome social problems is often imperative.

Adolescent↗
PubMed1975

[Long term therapy with nitrazepam in children with infantile spasms and myoclonic-astatic fits].

Since 1968 54 children with infantile convulsion and myoclonic-static fits have been treated with RADEDORM (minimum dosage 2x1/2 tablets, maximum 1--1,5 mg/kg body weight) in the Neuropediatric department of the University Pediatric Clinic in Leipzig. Most of the patients showed a retarded statical and mental development, 50% pathological neurological results. The results of the therapy (35% free of attacks; in 20% a reduction in frequency of attacks of 75--99%; in 6% of 50--74%, in 39% less than 50%, respectively no effect) can be said to be good. Myoclonic-astatic fits were semowhat less favourably influenced than infantile-convulsions. A combination with grand mal epilepsy also had a negative effect on such cases. The results of the treatment were independent of intelligence and duration of illness, however they were not so good in infants as in young children. The electroencephalogram showed with little exception a considerable conformity with the results of the treatment. The side-effects were relatively small and only seldom demanded a reduction in dosage.

Child, Preschool↗