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R Spatz

Publications and source records attributed to R Spatz.

At least 19 recordsLinked to original sources
PubMed1993

EEG alterations and seizures during treatment with clozapine. A retrospective study of 283 patients.

In a retrospective study, 1863 EEG recordings made during clozapine treatment of 283 patients with normal pretreatment EEG evaluations were analyzed. Furthermore, they were compared to the EEGs of the same patients without clozapine (i.e., during other neuroleptic medication). Moreover, the data of all patients who had seizures during treatment with clozapine were evaluated in case reports. Classical clinical EEG evaluation criteria for normal versus abnormal were used (including diffuse slowing and grouped alterations according to Jung 1953 and Kugler 1983). Of the 283 patients investigated, 61.5% (174) showed at least one abnormal EEG under clozapine according to these criteria. Evaluating all recorded EEGs of these patients in order to get some longitudinal information, we found a rate of 53.4% abnormal EEG recordings during clozapine treatment. Most of the EEG changes were evaluated as slight (22.5%) to moderate (10.1%) diffuse slowing and some as groups of nonparoxysmal waves (39.8%) or sharp waves (16.2%) rendering the EEGs abnormal according to the above criteria. Potential signs of increased bioelectrical cerebral reagibility such as paroxysmal activity (4.3%) or severe diffuse slowing (0.2%) were rare. A nearly linear correlation with the daily dose was found in the range up to 300 mg clozapine/day for both diffuse and grouped alterations. Possibly due to selection, adaptive mechanisms/habituation, and/or other unknown factors, the rate of alterations decreased slightly at doses above 300 mg and rose again sharply for doses over 600 mg/d. Three of the clozapine-treated patients, equivalent to 1.1%, developed seizures.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Sleep deprivation, epilepsy and the ability to operate a motor vehicle.

This study is based upon 207 examinations for the evaluation of the ability to operate a motor vehicle in persons with transient disturbances of the cerebral function. In 26 persons, the EEG was repeated after sleep deprivation. There was EEG activation with transient disturbances in seven cases (not present in the routine EEG). In five individuals, there were transient disturbances in the routine EEG as well as after sleep deprivation. No abnormalities were recorded in 14 persons. No driver's license could be granted in five patients with unequivocal spike wave complexes or spike wave paroxysms following sleep deprivation. In two patients, however, the permission to drive could be granted. These patients showed spike wave patterns in the routine EEG, but no seizures had occurred for several years and their performance in the experimental-psychological evaluation (with simulator) were superior. In persons with suspected and clinically obscure cerebral attacks, as well as in persons with known seizure disorder but seizure-free for several years, the EEG after sleep deprivation must be regarded as a highly informative test which may crucially influence the decision. The method of activation corresponds with a type of stress with which the motorist must deal frequently. This test can be carried out on an outpatient basis and with negligible iatrogenic damage.

Adult↗
PubMed1989

The efficacy of Cavain in patients suffering from anxiety.

The therapeutical efficacy of Cavain should be proved in the treatment of patients suffering from abnormal anxiety, psychosomatic complaints and psychoreactive disorder. Thus two randomized groups of patients (26 each) were treated in double-blind technique with either 2 x 200 mg daily Cavain or placebo for a period of 28 days. Prior to the beginning of the investigations and within 14 days intervals the Hamilton Anxiety Scale (HAMA) and the Adjective Check List (Janke and Debus) were applied. The global therapeutical improvement and compatibility were documented after 14 and 28 days. A significant superiority of Cavain in comparison to placebo could be found. Cavain acted anxiolytically and promotive on the subjective vitality-related performance. Therapeutical conclusions are discussed.

Adult↗
PubMed1982

Abnormal EEG activities induced by psychotropic drugs.

In a retrospective study involving 680 EEG investigations in 593 patients the effects of various psychopharmaceutical agents were examined by visual interpretation of the EEG. The drugs were given singly in the majority of cases and were combined in others, and special attention was paid to the occurrence of paroxysmal EEG activity. The proportions of abnormal EEGs in the various groups were (in descending order): clozapine 59%, lithium salts 50%, butyrophenone 44%, maprotiline 37%, dibenzepine 32%, laevomepromazine and amitriptyline 31%, imipramine 9% and diazepam 4%. The proportions of paroxysmal discharges (13%) and generalized transient disturbances with groups of slow waves (16%) were also greatest in the clozapine group. During 3.5 years (1973-1974, May 1979-November 1980) we observed drug-induced generalized seizures in 16 inpatients = 0.28% of all inpatients (N = 5785) in that time. The psychotropic drugs given to these patients were either laevomepromazine (Neurocil 4x), perazine (Taxilan 3x), maprotiline (Ludiomil 3x), clozapine (Leponex 2x), lithium carbonate (Quilonum retard 2x) and amitriptyline (Saroten 2x) alone or partly in combination with butyrophenone (3x), fluphenazine (2x) and biperiden (3x). The appearance of paroxysmal EEG activity seems dose dependent and occurs more often during treatment with a combination of psychoactive compounds, than in patients receiving a single drug.

Adult↗
PubMed1980

[EEG changes in abuse and addiction of bromide hypnotics [author's transl)].

With bromism we stated a slow EEG-activity. Such alterations of the electro-encephalogram can be caused by urea of bromine, its metabolites and by the inorganic bromide ion. We tried to find out the real effect of the bromide ion which is not bound in the serum. Therefore we only examined the EEG and the bromine serum after the acute influence of the urea of bromine had faded (> 5 days). Patients suffering of disturbances of metabolism or system-diseases, tumors and infections or patients undergoing a medicamentous therapy were excluded from these tests. During the years 1971, 1972 and 1977 we found 26 patients (bromine in serum > 5 mg%) who corresponded to the above mentioned conditions and on whose data the results of our studies are based. 16 patients had very high bromine values (> 24,6 mg%). Most of these patients (10 out of 16) showed paranoid-hallucinatory symptoms. We also stated delirious and depressive attacks. No one suffered of mental dullness. The EEG of 7 patients showed general alterations. With lower bromine values (< 24,6 mg%) we could neither state general alterations of the EEG nor psychotic or delirious symptoms. We didn't observe any paroxysmal disturbance of the EEG. We also didn't notice a acceleration of the EEG, as it was stated with other medical preparations.

Adolescent↗
PubMed1978

[The effect of the morphine antagonist naloxone on the effect of fentanyl].

1. In healthy volunteers fentanyl (0.15 mg i.v.) induces a reduction of awareness and vigilance and in some persons a transition to sleepiness or sleep stages. The course of these changes with time can be shown in narcograms, consisting of vigilance indices which correspond to the different EEG-stages. 2. Naloxon (0.4--1.6 mg i.v.) reduces the hypnotic effect of fentanyl or antagonizes it completely. 3. Index values of rapid eye movements in wakefulness measured oculographically indicate a reduction of motor activity after administration of fentanyl, when stages of reduced vigilance appear. Injections of naloxone following later on diminish this effect of fentanyl or antagonize it completely, not so does levallorphan.

Arousal↗
PubMed1977

[Symptom changes and rational therapy of vitamin B12 absorption disturbances (author's transl)].

Longterm parenteral therapy with the physiological depot form of vitamin B12 (aquocobalamin) is now the treatment of choice for pernicious anemia and funicular myelopathy. An optimal dosage scheme is given. High-dose oral and intrathecal applications of viatamin B12 are also possible in the individual case. If symptoms of neurological deficiency are already present in funicular myelopathy, additional physiotherapeutic measures, supervision of bladder function, prophylaxis of decubitus ulcers and contractures are necessary.

Anemia, Pernicious↗
PubMed1977

[Diagnostic value of the EEG. Neurologic diagnosis today].

The principal fields of application of the EEG are 1) the identification of transient functional disturbances - especially in cerebral seizures - which cannot always be reliably observed clinically, 2) the tracing of concomitant signs of substantial lesions which in the silent areas are not necessarily associated with isolated neurological defects and 3) the determination of the degree of severity of abnormalities when they do not agree with neurological or psychic disturbances. The discrepancies of the clinical findings themselves sometimes demand attention and benefit the patient when they lead to the identification of disturbances which could not at first be recognized. Selective indications, planned interrogation and thorough correlations with the clinical examinations and other findings are decisive for the value of the EEG in detail.

Brain Damage, Chronic↗
PubMed1977

[The EEG in hypercalcemia (author's transl)].

The EEG of 20 patients with hypercalcemia of different aetiology were investigated. (Hyperparthyreodism n = 14; Carcinomas with metastases n = 5; plasmocytom n = 1). General abnormalities were observed in most cases in different severity with a decrease of frequencies (n = 13) and an abnormal periodicity (n = 9). Beside one case there was a positive correlation between serum-calcium-level and EEG-abnormalities. Abnormal EEG-findings were observed mostly above serum calcium levels of 6,5 mval/1 = 13 mg%. There was a marked normalisation of EEG with decreasing serum-cacium-level. Different factors dealing with these abnormal EEG findings in hypercalcaemia were discussed.

Adult↗