PubMed Health⌕ Search

Biomedical subjects

Y Løyning

Publications and source records attributed to Y Løyning.

7 recordsLinked to original sources
PubMed1989

[Surgical treatment of epilepsy. Needs, examination, resource demands and results].

This review gives the current status of epilepsy surgery, the diagnostic procedures involved and the resources needed. Relatively few of the epilepsy patients are possible candidates for surgery. However, only a small fraction of these possible candidates are actually offered this treatment, in Norway as well as world-wide. The need for increased activity within this field is emphasized, as is the necessity of multi-disciplinary, regionalized epilepsy centers.

Epilepsy↗
PubMed1988

Surgical treatment of epilepsy. Organization (localization, staff, referral procedures).

Small countries like Norway (4.2 mill. people), should centralize surgical treatment for epilepsy around a permanent team from one comprehensive epilepsy service center and the cooperating university regional hospital. The first phase of the selection procedures should be done at all regional university hospitals and at the epilepsy center. The second phase with WADA-test and ictal EEG-recordings and video-observations, and the third phase with EEG-recordings from intracranial electrodes, should be carried out by the permanent team. After implantation of electrodes at the regional hospital the intensive observation and recordings should be performed at the epilepsy center. The per-operative diagnostic procedures, with corticography, depth recordings, and localization procedures, should be carried out by the permanent team. After the operation, the patient should be referred to the epilepsy center for establishment of proper medical and psychosocial follow-up and rehabilitation. Preferably, the post-operative assessments over several years should be carried out by the permanent team.

Adult↗
PubMedDate not supplied

A double-blind study comparing oxcarbazepine and carbamazepine in patients with newly diagnosed, previously untreated epilepsy.

Two hundred and thirty-five patients suffering from newly diagnosed epilepsy were randomly allocated to treatment with either oxcarbazepine or carbamazepine in a double-blind multi-centre study. After a titration phase (between 4 and 8 weeks), the optimal individual dose of trial medication was determined and treatment with that dose was continued for another 48 weeks. The criteria for assessment were: efficacy--seizure frequency, EEG tracings, global evaluation; tolerability--side effects observed by the patient or the investigator, laboratory tests; other assessments--blood pressure and heart rate, carbamazepine and 10,11-dihydro-10-hydroxycarbamazepine trough serum levels. The results of the study showed the following: no significant difference in seizure frequency between oxcarbazepine and carbamazepine; no correlation between the therapeutic effect and the EEG findings in either treatment group; oxcarbazepine caused significantly fewer (P = 0.04) 'severe' side effects than carbamazepine; global evaluation of tolerability demonstrated a trend towards the better tolerability of oxcarbazepine; no correlation was observed between either efficacy or tolerability and the actual serum trough levels of antiepileptic drugs; clinically relevant abnormal laboratory test findings were observed in 2 patients, both on carbamazepine. The authors consider oxcarbazepine to be a valuable alternative to carbamazepine, particularly in patients who develop side effects which prevent optimal seizure control.

Adolescent↗
PubMedDate not supplied

Association between regularly occurring complex partial seizures and thyroid function parameters.

A 28-year-old man with regularly occurring clusters of complex partial seizures was studied over a total of 224 days. His seizure periods lasted 2-4 days and occurred at intervals of 5-6 weeks. Several parameters were studied. The most striking finding was an increase in the serum concentration of thyroxine prior to and during the seizure periods. The concentrations of urine catecholamines and serum cortisol also varied with the seizure periods, but these hormones increased after the seizure periods had begun. To determine if there is a general 4-6-week rhythm in thyroid hormone concentrations, 12 weekly blood samples from 10 healthy male students were analyzed. No rhythmicity was found.

Adult↗
PubMedDate not supplied

Surgical versus medical treatment for epilepsy. I. Outcome related to survival, seizures, and neurologic deficit.

We conducted a retrospective parallel longitudinal cohort study comparing surgical and medical treatment for epilepsy. The surgical group contained 201 patients treated with resective surgery for epilepsy in Norway since the first operation in 1949 until January 1988. The 185 control group patients treated medically only were closely matched for year of treatment, age at treatment, sex, seizure type, and neurologic deficit before treatment. There was no significant difference in survival between the two groups. The total monthly seizure frequency in the first and second year after operation and last year of registration (median 9 years) was significantly lower in the surgical group than in the control group (Mann-Whitney U test, two-tailed p less than 0.0001). The patterns were similar, with significant differences for subgroups with similar pretreatment status, such as seizure frequency, age, etiology and EEG-focality. Twenty-three and four-tenths percent (n = 40) of the surgically treated, and 2.9% of the controls had contracted neurologic deficits within 2 years after treatment. The difference was significant (chi square = 32.89, p less than 0.0001). Psychosis or permanent psychotic symptoms were reported in 6.7% (n = 11) of the surgically treated patients, and we suspect a higher proportion of psychotic development in the surgical group than in the control group. We conclude that surgical treatment for partial epilepsy is more successful than medical treatment in producing seizure reduction, provided the indications for operation exist. Surgical treatment produces more neurologic deficits than medical treatment (and possibly more psychiatric morbidity), and this factor must be weighed against the reduction in seizure frequency. The two treatments are equal for longterm survival.

Adolescent↗
PubMedDate not supplied

Surgical versus medical treatment for epilepsy. II. Outcome related to social areas.

We conducted a retrospective parallel cohort study comparing surgical and medical treatment for epilepsy. The surgical group contained all 201 patients treated with resective surgery for epilepsy in Norway since the first operation in 1949 until January 1988. The 185 patients in the control group, medically treated only, were closely matched for year of treatment, age at treatment, sex, seizure type, and neurologic deficit before treatment. Between 75 and 95% of the survivors (median 17 years after treatment) completed two questionnaires on their social situation. Although surgical treatment improved the seizure situation (about one-fourth had some neurologic deficit), a considerably smaller long-range influence on different social aspects was observed. There were no significant differences between the two groups in educational status, social pensions, social status, marital status, fertility, dependency in residential situation, the need for aid in daily activities of living (ADL), or the need for being looked after, when we controlled for pretreatment status. In all, 25.3% of the surgically treated patients and 8.5% of the controls were not receiving anti-epileptic drugs (AEDs) at the time of investigation (Mann-Whitney U test, two-tailed p = 0.0011). A considerably higher proportion of the surgically treated (53.2%) than control patients (24.2%) claimed that the treatment had improved their "working ability" (Mann-Whitney U test, two-tailed p less than 0.0001), but this resulted in significant improvements in the actual working situation only for those in regular education or work before treatment (chi 2 = 6.514, p = 0.038).

Cohort Studies↗