PubMed Health⌕ Search

Biomedical subjects

W Fröscher

Publications and source records attributed to W Fröscher.

At least 55 records · Page 3Linked to original sources
PubMed1985

[Antiepileptic monotherapy and combination therapy of simple focal seizures].

According to present state of literature complete seizure control can be obtained in about 50% of patients with simple partial seizures. In several studies on previously untreated patients with simple partial seizures most patients became seizure-free with carbamazepine or phenobarbital or phenytoin or primidone or valproic acid used as monotherapy. Previous experience has shown that in patients whose seizures are not completely controlled by monotherapy drug combinations like carbamazepine with phenobarbital or primidone or valproic acid and phenytoin with phenobarbital or primidone or valproic acid should be initiated. Several animal experiments are suggestive for a synergistic effect of different antiepileptic drugs. In a previously published study on carbamazepine monotherapy, 6 out of 9 patients with simple partial seizures became seizure-free or improved markedly by this treatment.

Adolescent↗
PubMed1985

Free level monitoring of carbamazepine and valproic acid: clinical significance.

The recently available ultrafiltration technique facilitates determination of the free drug serum concentration of several antiepileptic drugs. For this reason a reappraisal of the clinical significance of free level monitoring was thought necessary. In this study on 203 patients receiving carbamazepine monotherapy and 101 patients receiving valproic acid monotherapy, the total and free drug levels were correlated with therapeutic outcome and side effects. Our investigations indicated no closer correlation between free concentration and seizure reduction or side effects than between total concentration and effectiveness or side effects. However, we found a close correlation between total and free concentrations.

Adolescent↗
PubMed1985

[Grand mal status and grand mal series--causes, therapy and course].

This retrospective study includes 15 patients with grand-mal status and 17 patients with a series of grand-mal seizures. 8 patients with a grand-mal status never had seizures before. Encephalitis was the most common cause of a grand-mal status in our patients. As a rule, duration of a grand-mal status was less than 10 hours and comprised 8 seizures on average with seizure intervals less than one hour. The initial treatment of the grand-mal status consisted above all of phenytoin, diazepam or phenobarbital, or a combination of these drugs. 3 patients died within 2 months after the beginning of the status. Series of grand-mal seizures were observed mainly in patients with a preexistent seizure disorder; brain damage of early childhood was the most common cause which could be detected. The duration of a series of grand-mal seizures was 13 hours on the average, comprising 4 seizures with an interval of more than 1 hour. Phenytoin and/or diazepam proved to be an efficient initial medication. One of 17 patients died. The most common provoking factor in case of status and series were medication mistakes. The preferential drugs in the initial treatment of status and series of tonic-clonic seizures are the benzodiazepines (above all, clonazepam and diazepam) and phenytoin. The referral to an intensive-care unit is highly recommended. If seizures persist, treatment is continued with barbiturates (phenobarbital, thiopental).

Adolescent↗
PubMed1984

Intensive follow-up monitoring in patients with once daily evening administration of sodium valproate.

For 18 previously untreated patients with absence, myoclonic, or grand mal seizures--or combinations--results of clinical and electroencephalographical monitoring are reported. Sodium valproate was given once daily in the evening. Monitoring included repeated 24-48 h EEG recordings and drug blood level measurements. Results indicated the evening monodose to be an adequate therapeutic schedule for a considerable number of patients. Apart from the aspect of simplification, a further important aim is to individually minimize the drug dose. An average of 15.6 mg/kg sodium valproate (range, 10.0-25.5 mg/kg) per day was administered. In some cases the EEG discharge activity continued to be lowered even after the drug blood level had reached steady state. With medication, frequency and total duration of paroxysms were significantly lowered (by more than 90%) in over 80% of the patients, whereas the mean duration of paroxysmal activity did not change uniformly. Before treatment, short paroxysms (1-5 s) were seen together with longer ones in 11 patients. During treatment either all paroxysms disappeared or, in cases of remaining activity, most discharges were short and not accompanied by seizure manifestations. Blood level profiles over 24 h showed maximal values between midnight and 2 a.m. The minimal values (about half of the maximum) were found between 10 p.m. and midnight. The 8 a.m. value was 70-80% of the maximum. Only three patients complained of slight side effects (temporary drowsiness, loss of hair). Because of the simplified handling, the relatively low dose per day, and the few side effects, it seems possible that for primary generalized epilepsies once daily evening administration of sodium valproate is appropriate without diminishing the antiepileptic effect.

Adolescent↗
PubMed1984

[EEG activation with bemegride in epilepsy diagnosis. 1: Literature review].

In patients with suspected epilepsy, an EEG "activation" with bemegride can be performed as last link of the diagnostic chain. The administration of bemegride intends the activation of epileptiform discharges in the EEG of patients with a disposition for epilepsy. This activation is not supposed to occur in healthy subjects at the same dosage. The occurrence of generalized and focal epileptiform discharges during the intravenous administration of bemegride is regarded as a positive test result by most investigators. Changes like a slowing of the background activity, dysrhythmias, parenrhythmias, and focal changes are not reliable. The provocation of seizures should be avoided. Dosage and injection rate must be chosen in such a way that false negative results are more probable than false positive. The result of the bemegride test is influenced by sex, type of seizures, age and alcohol intake. Slight side effects of the intravenous administration of bemegride are relatively common, severe side effects rather uncommon when the test is carefully performed. According to the literature and personal experience, the activation of typical epileptiform discharges in the EEG by bemegride in adults with doubtful episodes of unconsciousness indicates the possible presence of epilepsy (epileptic seizures respectively), but does not confirm this. In our opinion, the bemegride test is contraindicated in patients with established epilepsy (epileptic seizures respectively) or in cases in whom the occurrence of epileptic seizures is probable.

Adolescent↗
PubMed1984

[EEG activation using bemegride in the diagnosis of epilepsy. 2. Catamnestic studies].

43 patients were evaluated catamnestically 5-10 years after a bemegride test in order to proof its relevance. The bemegride test was considered as diagnostically helpful in 37 cases (86%) based on observations of the course. It had been false negative in four cases (9,3%), and false positive in two cases (4,7%). The occurrence of epileptic attacks is indicated by the activation of regular and irregular spike-wave complexes as well as other specific epileptic discharges. These could be activated by an average threshold of 68,5 mg or 1,09 mg/kg body weight in 86,2% of all patients with epileptic attacks. The threshold dose was lower in cases of primary generalized attacks than in complex focal attacks. The indication for the bemegride test is restricted.

Adult↗
PubMed1984

[Combination therapy with carbamazepine and valproic acid in problem cases at an outpatient epilepsy clinic].

A total of 64 problem patients with epilepsy (42 retrospective evaluations, 22 prospective cases) was treated with the combination of carbamazepine and valproic acid. Most frequent seizure types were tonic clonic (focal origin or primarily generalized), complex partial ones, and absences. Best results were observed in patients with tonic clonic seizures in contrast to complex partial ones. The pattern of adverse reactions (none of significant severity) was according to those of monotherapies with the compounds. In cases with relevant improvement serum levels of carbamazepine and valproic acid were within the range commonly described for monotherapies.

Adult↗
PubMed1983

[Chronic trichinosis and neuromuscular diseases. Morphologic and pathogenetic aspects].

Muscle biopsies were carried out on five patients affected by a chronic neuromuscular disorder, mostly in the form of a spinal muscle atrophy. All patients had suffered from acute trichinellosis many years before, the interval between acute parasitic infection and the appearance of the slowly progressive neuromuscular syndrome being of 21, 13, 35, 26 and 16 years respectively. In biopsy specimens, morphological and enzyme-histochemical changes typical of a progressive neurogenic muscular atrophy were present; in addition, encapsulated but still living, enzyme-positive parasites and signs of focal myositis were detected. The possible pathogenetic correlations between the "chronic" trichinellosis and the "degenerative" neuromuscular disorder are discussed.

Aged↗
PubMed1982

[Chronic trichinellosis and neuromuscular diseases: clinical, serological and therapeutic observations].

In six males with chronic neurological signs who, 14-41 years previously, had an episode of acute trichinellosis cardinal symptoms were chronic muscle pain and lower-neuron damage. Other findings, probably related to trichinellosis, were episodes of pyrexia, chronic gastro-intestinal and cardiac symptoms, and in one case symptomatic epilepsy with psychomotor attacks. Significant laboratory findings were a chronic leukocytosis in one case, repeated elevations of eosinophil count in three. Muscle biopsy in all patients revealed live trichinella and (or) focal myositis. The serological findings did not correlate with the biopsy ones. If the live trichinae are encapsulated, antibody titres may be negative, while they may be markedly elevated when the trichinellae are dead. Whether encapsulated larvae can be influenced by tiabendazol or mebendazol is not clear from these observations.

Adult↗
PubMed1982

[Study on the constancy of EEG characteristics in epileptic patients (author's transl)].

These investigations were based on the question regarding the reliability of a single EEG recording in patients with epilepsy. 114 patients patients (age 11-74 years, median 33 years) underwent five EEGs at an interval of three months during a period of one year. A "constant" characteristic was a continuously developed dysrhythmia. "Moderately constant" was an intermittent dysrhythmia, an alpha background activity and a general slowing of the background activity. "Inconstant" was a "parenrhythmia" and focal disturbances as well as epileptiform patterns. Similarly inconstant was the lateralization of epileptiform patterns. The lateralization of focal disturbances and a dysrhythmia was moderately constant. The great constancy of a continuously developed dysrhythmia makes it hardly suitable for a functional follow-up. The applications of epileptiform patterns and focal disturbances for therapy planning is, however, limited due to their inconstancy. Because of its moderate constancy the background activity (in different recordings) is a suitable indicator for an overdosage of antiepileptic drugs.

Adolescent↗
PubMed1981

[Rat bite disease with meningoencephalitic involvement].

Reported is the case of a 32 years old man, who developed a severe condition with recurrent fever episodes, lymphadenopathy, liver and spleen enlargement, and severe headaches 6 weeks after having been bitten by a rat. The headaches even increased during the further course. Psychological tests indicated an increased instability and irritability. The brain scan revealed diffuse cerebral ischemias (on the basis of an increased cerebrovascular resistance). Following the treatment with penicillin, the symptoms cleared almost completely. Although the pathogenic organism could not be identified, the findings and the clinical course of the disease indicate the presence of sodoku with meningoencephalopathic involvement.

Adult↗