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Cerebral birth injury as a cause of epilepsy.

The possible role of cerebral birth injury in the aetiology of epilepsy was evaluated by comparing the birth histories of 101 epileptic patients with focal seizures and 208 with non-focal seizures. The former were smaller at birth and their mothers were older and had higher blood pressures than the mothers of the latter. Although the two groups did not differ significantly with regard to the frequency of breech birth, assisted vaginal breech deliveries were significantly more numerous in the focal group. The injured half of the brain was as often pressed against the sacrum as against the symphysis during birth.

Adult↗

[Alterations in several cerebral metabolic indices in patients with epilepsy].

The paper pertains to studies of some metabolic indices in the brain of 106 epileptic patients where fits were of a traumatical and inflammatory etiology and with the duration of the disease from 1-10 years. The examination revealed disorders of the reductive-oxidative processes and carbohydrate metabolism in the brain which were not related to the etiology of epilepsy. A disorder of reductive-oxidative processes were more expressed in focal nonconvulsive fits characteristic for temporal epilepsy. The authors point to a certain correlation between changes in biochemical indices and the duration of the disease.

Adolescent↗

[Brain damage and epilepsy in childhood (author's transl)].

Among the 1100 patients with convulsive disorders attending out-patient paediatric clinics of the Universities of Vienna and Graz, there are 14 cases of postnatal posttraumatic epilepsy. The characteristic features of this condition, as evidenced even by this small group of patients are focal epilepsy with focal paroxysms in the EEG, often combined with neurological defects and psychological abnormalities, but more seldom with defects of intelligence; resistance to anticonvulsive drugs is a frequent observation. In a retrospective study such as this, the criteria which could predict the development of epilepsy following posttraumatic brain damage are not sufficiently accurately definable; prospective serial studies on brain-damaged children would be of greater prognostic value. The following parameters seem to be important: the kind of brain damage, the duration of unconsciousness, the frequency of initial convulsive attacks and the persistance of the progression of the EEG changes.

Adolescent↗

Posttraumatic epilepsy and CT scan.

Among 83 head-trauma cases examined by CT scan in a later year, 41 were included in a seizure group of those who clinically showed late epilepsy and who obviously showed epileptic discharge such as spike or spike and wave in EEG after trauma, and 42 were included in a nonseizure group of those who had some sequelae such as abnormal findings in EEG or neurologic defects: the CT findings of these 83 cases were collected and compared with clinical findings, EEG, and other data. The CT findings of these cases were divided into five groups: (A) a normal group; (B) a group showing partial or unilateral ventricular dilatation; (C) a group showing porencephaly in the cerebral parenchyma; (D) a group suspected of cortical atrophy; (E) a group of other cases. Group D contained 44.3% of the cases, and was the largest group; the frequency of seizure was highest in Group C. The CT classification reveals the contradiction of the conventional definition of posttraumatic epilepsy and also poses some problems concerning the disease. CT scan is mostly applied to head trauma in the acute stage, and as for trauma in the chronic stage there are a few reports on chronic subdural hematoma and post-traumatic hydrocephalus. We noticed posttraumatic epilepsy among the sequelae of trauma, and then analyzed CT findings of the epilepsy: the results are reported here.

Adolescent↗

Brain damage in National Hunt jockeys.

Five National Hunt jockeys have been found to have post-traumatic encephalopathy- three with epilepsy and two with significant intellectual and psychological deterioration. Closer supervision is needed.

Adult↗

Transient global amnesia--a review of 213 cases from the literature.

TGA is a clearly recognisable clinical syndrome with many and varied aetiologies, the most ubiquitous being transient cerebral ischaemia. This entity is probably much more common than the literature suggests, many patients not coming to the attention of a physician due to the transient nature of the isolated memory defect and the risk of recurrence being low, it is of interest that many of the original patients described tended to be the more prominent members of the community, e.g. physicians and relatives of physicians, perhaps suggesting that the occurrence of TGA in such a person is less likely to pass unnoticed. In the differential diagnosis one should include the following: transient cerebral ischaemia, epilepsy, migraine, temporal lobe encephalitis, psychogenic fugues, post-traumatic, and rarely cerebral neoplasms.

Adult↗