Biomedical subjects
Publications and source records attributed to S Chayasirisobhon.
We treated 52 mentally retarded patients with intractable seizures by adding valproic acid (VPA) to other drug regimens. Sixty-one percent improved clinically. VPA significantly reduced the frequency of generalized tonic-clonic seizures, generalized myoclonus, absence and atonic seizures. There was a significant correlation between clinical improvement and reduction of EEG paroxysmal activity.
The brain stem auditory evoked potential (BSAEP) was recorded in 32 normal control subjects and 81 epileptic patients. Statistically significant differences in regard to sex and laterality of ear stimulated were found to exist in both groups. The epileptic patients also had significantly longer latencies for all wave components and interwaves I-III as well as I-IV than the normal controls. There were no differences in regard to interwave latency III-V. Clinically significant latency prolongations (more than three standard deviations from the norm) were encountered especially in regard to waves I and III. Correlations of wave and interwave latencies with a large variety of clinical variables showed that statistically significant relationships existed mainly in regard to presence or absence of brain damage and the severity of the seizure disorder, as expressed by the number of different seizure types to which a given patient was subject. Waves II and III showed the most consistent latency prolongations for these variables. Anticonvulsant medication levels did affect wave latencies, but apart from Primidone, it involved waves IV through VII rather than II and III. Carbamazepine levels were related to prolongation of I-III interwave latency. It is concluded that severely brain-damaged epileptic patients have demonstrable brain stem dysfunction affecting mainly the medullo-pontine rather than midbrain or thalamic structures.
A case is reported in Montreal of human cysticercosis in a 44-year-old man who emigrated from Italy in 1956. Numerous subcutaneous nodules were found throughout his body. X-ray of his thighs and chest showed oblong calcific densities measuring 1 x 0.5 cm in size. Examination of an excised nodule from the right biceps revealed a cysticercus larva morphologically similar to Cysticercus cellulosae although the scolex lacked hooks. On the basis of the intensity of infection, focal and generalized epileptic seizures, changes in the CSF, and well demarcated lucencies observed in brain scan, cerebral cysticercosis was considered the most likely diagnosis.
The present study evaluated the efficacy of the Sepulveda Epilepsy Education program (SEE), using a controlled outcome design. SEE is a 2-day psychoeducational treatment program designed to provide medical education and psychosocial therapy. Thirty-eight outpatients, matched according to seizure type and frequency, were randomly assigned to treatment (n = 20) or waiting-list control (n = 18) groups. The major outcome measures used were a 50-item true-false test specifically designed to evaluate the SEE program, the Washington Psychosocial Seizure Inventory, the Beck Depression Inventory, Lubin's Depression Adjective Checklist, the State-Trait Anxiety Inventory, the Acceptance of Disability Scale, and Sherer's Self-Efficacy Scale. Significant differences between the two groups were found on the three major subscales of the 50-item true-false test. The treatment group demonstrated a significant increase in overall understanding of epilepsy, a significant decrease in fear of seizures, and a significant decrease in hazardous medical self-management practices. In addition, an objective measure of blood levels of antiepileptic drugs (AEDs) showed the treatment group to have a significant increase in medication compliance.