MMPI in differentiation of temporal lobe and nontemporal lobe epilepsy: Investigation of three levels of test performance.

Using carefully matched samples, a variety of MMPI techniques were explored in an attempt to document the clinically accepted personality differences between temporal lobe (n?=?37) and nontemporal lobe (n?=?28) epileptics. Analysis of the traditional clinical scales, as well as additional procedures employed in an attempt to improve test sensitivity (content scales, code type, category frequencies, and item analyses), did not support the position that temporal lobe epileptics are more likely to manifest personality disturbance than are other epileptics. (10 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychosocial study of epilepsy in Africa

As documented by many authors, the social position of epileptics in many small scale societies of Africa is marginal at best, and is often characterized by rejection, discrimination, even ostracism. Such negative and noxious attitudes toward persons suffering from epilepsy are rooted in traditional beliefs about causes and nature of convulsive disorders and these have parallels in European history. This article focuses on the psychosociocultural aspects and indigenous concepts of epilepsy, on popular attitudes towards, and social status of, sufferers from epilepsy in a Tanzanian tribal population. The authors present a comparative analysis of focus group discussions conducted with epileptics and with matched controls in two isolated communities. In one community (Mahenge) a clinic for epilepsy has been operating for over 36 years, with a public education component during the last four years, whereas in the other community (Ruaha) epileptics have only been sporadically treated in a small mission dispensary and people have had little opportunity to learn about the nature and modern treatment of convulsive disorders. The responses obtained in focus group discussions reflect the significant change in notions about the illness, in the attitude toward and in the social status of epileptics in Mahenge, while the people of Ruaha still regard epilepsy as a typical "African" affliction fraught with supernatural danger and not effectively treatable by modern medicine.     

Epilepsy, retarded growth and onchocerciasis, in two areas of different endemicity of onchocerciasis in Burundi

A high prevalence of epilepsy (up to 1.3%) was observed in an area hyperendemic for onchocerciasis in the province of Bururi, Burundi. Following this observation, epileptics and controls were examined in 2 communes (administrative units) with different endemicity for onchocerciasis. Altogether, onchocerciasis was more frequent in epileptics (81.8%) than in controls from the same households (68.3%; P < 0.05). This difference was more marked in the hyperendemic area. Other possible causes of epilepsy, including cysticercosis, were infrequent (18 possible cases among 110 epileptics). During this survey, 9 epileptics with growth retardation were seen. They showed most characteristics of Nakalanga syndrome, which was described from Uganda. All 9 such cases were suffering from onchocerciasis. These findings give more evidence of a possible association between onchocerciasis and epilepsy, and between onchocerciasis and Nakalanga syndrome.     

Similarity of personality trait interrelationships in persons with and without epileptogenic cerebral dysfunction.

Questioned whether or not personality tests measure the same traits in brain-injured and non-brain-injured samples. It was hypothesized that, in a sample of epileptics, personality trait interrelationships would be similar to those found in non-brain-injured samples. Using the CPI and EPPS intercorrelation matrices of 199 epileptics contrasted with normative sample matrices from both test manuals, the hypothesis was confirmed for the epileptics. Further confirmation considering variables such as severity and laterality of pathology was suggested. The implication from K. Goldstein's work that brain injury per se produces a general qualitative dissimilarity in personality trait interrelationships did not appear tenable. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sex differences in the neuropsychological functioning of epileptics.

Compared the performance of 137 male and 113 female epileptics on a comprehensive neuropsychological test battery (e.g., WAIS, 3 Wide Range Achievement Test subtests, a modified Halstead-Reitan Neuropsychological Test Battery, and Babcock Story Recall Test). Significant differences were found for 12 of 33 test comparisons, with the pattern of results resembling sex differences found among neurologically normal Ss. Although the most pronounced differences were obtained on motor speed and strength measures, an illustration was provided of how subtle effects found for more complex tasks may affect diagnostic decisions. Theoretical implications of these findings for the Sex by Functional Brain Asymmetry interaction noted by other investigators are discussed. (7 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Anticonvulsant-induced changes in tissue manganese, zinc, copper, and iron concentrations in Wistar rats

Human epileptics have been reported to have low blood manganese (Mn) concentrations in comparison to nonepileptics, an observation that is important because Mn deficiency can increase seizure susceptibility in experimental animals. Factors that have been suggested to contribute to the low blood Mn levels in epileptics include anticonvulsant use, seizure-induced tissue redistribution of Mn, and genetics; in the present study, the first of these possibilities was tested. Wistar rats were fed semipurified diets containing diphenylhydantoin ([DPH] 3 g/kg diet), phenobarbital ([PB] 2 g/kg diet), or primidone ([PRIM] 3 g/kg diet) for 7 weeks, at which time they were killed and tissues collected and analyzed for Mn, zinc (Zn), copper (Cu), and iron (Fe) concentrations. In comparison to pair-fed rats, DPH- and PRIM-fed rats had significantly elevated liver Mn concentrations, while Mn concentrations in blood, brain, heart, and kidney were unaffected by anticonvulsant exposure. Changes in the concentrations of Zn, Cu, and Fe in specific tissues were also found. Overall, these findings suggest that the anticonvulsants tested do not lead to significant derangements in the metabolism of Mn.     

Identification of neuropsychological deficits in epilepsy using the Luria-Nebraska Neuropsychological Battery.

80 hospitalized patients, 22 diagnosed as having idiopathic seizures, 18 who developed epilepsy secondary to brain trauma or another CNS disorder, and 40 who demonstrated no evidence of CNS involvement, were given the Luria-Nebraska Neuropsychological Battery. Mean ages of Ss were 38.3, 35.2, and 41.1 yrs, respectively. Results demonstrate that the standardized Luria test may be useful in the evaluation of neuropsychological deficits in adult epileptics. (6 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Quantitative analysis of interictal behavior in temporal lobe epilepsy

Patients with unilateral temporal epileptic foci were contrasted with normal subjects and patients with neuromuscular disorders in the evaluation of specific psychosocial aspects of behavior. Eighteen traits were assessed in equivalent questionnaires completed by both subjects and observers. The epileptic patients self-reported a distinctive profile of humorless sobriety, dependence, and obsessionalism; raters discriminated temporal lobe epileptics on the basis of circumstantiality, philosophical interests, and anger. The right temporal epileptic displayed emotional tendencies in contrast to ideational traits of left temporal epileptic. Right temporal epileptics exhibited "denial," while left temporal epileptics demonstrated a "catastrophic" overemphasis of dissocial behavior. The results support the hypotheses that sensory-affective associations are established within the temporal lobes, and that, in man, there exists a hemispheric asymmetry in the expression of affect.     

The influence of rehabilitative factors on the behavior and affect of epileptics

First experience in the occupational rehabilitation of a group of less gifted juvenile epileptics is reported. In this paper, the emphasis is on both psychological and sociopsychological aspects of rehabilitation. The observation and control of processes and reactions is of major importance to the entire program of rehabilitation. Also, the improvement of the occupational situation of a patient will have a positive influence on his social behavior, self-confidence, and emotions. Rehabilitation is a complex process, with the results depending to a very large extent on extremely methodical approaches.     

The synthesis and in vitro characterization of the mucoadhesion and swelling of poly(acrylic acid) hydrogels

Depression is a significant problem in epilepsy. Suicides occur in epileptic patients five times more often than in general population. Material included 34 epileptics with 76 suicidal attempts and 24 patients with no history of suicide. Psychical state was studied with Beck Depression Inventory and Hamilton Depression Rating Scale. In the group with suicidal attempts 65% of patients had depression (54.5% of them had major depression) and in group without suicide attempts depression was noted in 54% (23% with major depression). Patients with depression were divided into two groups: group I with suicidal attempts and group II without history of suicide. In group I more patients were alcohol abusers (50% vs 31%), more were treated because of epilepsy longer than 10 years (59% vs 46%) and more had tonic-clonic seizures (82% vs 46%). In group I, 54% of patients were on polytherapy (more than half of them with fenobarbital). In group II, 31% of epileptics were on polytherapy (no one with fenobarbital). Major depression was significantly more frequent in epileptics with suicidal attempts. The severity of depression may influence the risk of suicide. Major depression may be associated with late age of onset of epilepsy, longer treatment duration, tonic-clonic seizures, polytherapy (mainly with fenobarbital) and alcohol abuse.     

Are short-stay admissions to an acute general medical unit appropriate? Wellington Hospital experience

AIM: This audit was performed to ascertain whether the admission of patients to the General Medical Unit (Wellington Hospital) for one day or less was appropriate. METHODS: Between 1 July 1996 and 30 June 1997, 494 patients were admitted to General Medicine for one day or less. The medical records for a random sample of 245 patients were reviewed. A modification of the Oxford Bed Study Instrument was used to assess the appropriateness of admission. RESULTS: Twenty admissions (8.2%) were deemed inappropriate, six patients could have been referred to medical outpatients, four were known epileptics who presented following a seizure, and none of the others merited admission on severity criteria. Ten patients were triaged after 10.00 pm, when discharge becomes more difficult. Forty-two patients required an investigation which delayed discharge. CONCLUSION: With the present community and investigation facilities available, there is no evidence that the majority of 24-hour admissions to acute General Medicine are inappropriate.     

Production of associative sequences in schizophrenia and chronic brain syndrome.

"… timing differences in the associative process of schizophrenics and epileptics" was studied. Recall and a "condition of restricted association were employed… . controls were found to differ from the patient groups with respect to gross output of words… . As increased restrictions were imposed on the associative process, disturbances in the thinking of the pathological groups became more apparent… . results suggest that inappropriate responses (intrusions), which appear in the productions of psychotic individuals, are but symptomatic of a more basic disturbance in thought processes… . [Results] discussed within the framework of Hebbian theory and in relation to other theoretical formulations." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of KT-362, a sarcolemmal and intracellular calcium antagonist, on calcium transients of cultured neonatal rat ventricular cells: a comparison with gallopamil and ryanodine

During the years 1990-92 in the Regional Poisons Control Center in Sosnowiec 42 epileptics (20 females and 22 males) were hospitalized because of suicide attempt. It amounted to 9% of all attempters, treated there in this period. The majority of patients were males of age range from 21 to 62 years. In 23 patients the suicide attempts were performed for the first time. the main reason for suicide was the family conflicted situation. Additionally, in 14 patients the poisoning attempts have been done during alcohol abuse. In the suicide attempts the antiepileptic drugs were most frequently used, mainly carbamazepine (23 cases).     

Legal aspects of epilepsy and coexisting psychiatric disorders

Major advances in understanding the neurobiology of epilepsy have led to more precise diagnosis, early rational treatment with new drugs, useful new neurosurgical techniques, etc. This has led to significant control of seizures, a marked reduction in concurrent psychopathology, improved quality of life of the epileptic patient, the almost complete abolition of old-style institutions for these patients, etc. However in spite of greater scientific knowledge about epilepsy, this has not led to an equally great advance socially. Old-fashioned restrictions and limitations based on mistaken ideas as to the nature of epilepsy still remain. Epilepsy is still considered in the same light as the psychopathological disorders seen in some epileptics, as a result of different variables which are not necessarily related to seizures. Current legal rulings on epilepsy, with or without co-existing mental disorder, are reviewed in relation to their effect on driving motor vehicles, carrying out military service, the condition of minusvalia, the possibility of legal incompetence, and the nullity of marriage and of priesthood. It is concluded that although the limitations maintained by some statutory requirements are reasonable, it would be fairest to abolish restrictions which, in view of present scientific knowledge, are out of date and prevent the return to normal and full social integration which should prevail for people with epilepsy.     

Sudden unexpected death in epileptics following sudden, intense, increases in geomagnetic activity: prevalence of effect and potential mechanisms

Abrupt, intense increases in global geomagnetic activity during the local night may precipitate a significant proportion of sudden unexpected (or unexplained) deaths (SUD) in epileptics. Over a 2-year period SUD in healthy chronic epileptic rats occurred when the average daily geomagnetic activity exceeded 50 nT (nanoTesla) and suddenly began during local night. Other experiments demonstrated that epileptic rats displayed more spontaneous seizures per night if there had been sudden increases in geomagnetic activity. Analyses of previously published data indicated that the number of SUDs/month in a population of human epileptics was positively associated with the number of days/month when the average geomagnetic activity exceeded 50 nT. The results support the hypothesis that suppression of the nocturnal concentrations of the endogenous anticonvulsant melatonin by sudden increases in geomagnetic activity may encourage fatal cardiac arrhythmias by uncoupling the insular/amygdaloid-paraventricular hypothalamic-solitary nucleus pathways.     

Hemisphere deconnection and unity in conscious awareness.

Describes experiences with advanced epileptics in whom an extensive midline section of the cerebral commissures had been carried out in an effort to contain severe epileptic convulsions not controlled by medication. The most remarkable result of this operation was the apparent lack of effect on ordinary behavior. However, among the most significant symptoms, collectively termed as the syndrome of hemisphere deconnection, was an apparent doubling in most realms of conscious awareness. Each hemisphere seemed to have its own separate and private sensations, perceptions, concepts, and impulses to act, with related volitional, cognitive, and learning experiences. Appartus for studying the lateralization of visual, tactual, lingual, and associated functions in the separated hemispheres is described. Observations led to the opinion that the minor hemisphere constitutes a 2nd conscious entity that is characteristically human and runs along in parallel with the more dominant stream of consciousness in the major hemisphere. (20 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Use of the Horsley-Clarke stereotactic frame in humans

It is well known that the Horsley-Clarke frame (HCF) was developed and engineered by the British physicians Robert Henry Clarke and Victor Horsley in 1906 for use in animals. It is less appreciated that the HCF was also used by the Frederic Gibbs group in 1947 for studies of human epileptics. Subcortical depth electrodes were placed using the relationship between external landmarks and intracranial structures and confirmed by pneumoencephalography. Events leading to the development of the HCF and its subsequent use in humans for depth recordings, and lesion production in the treatment of epilepsy, movement disorders, and psychosurgery are discussed.     

Factors affecting growth and urease production by Trichophyton spp

BACKGROUND: Two to four percent of epileptics have their seizures triggered by flickering light, an effect which may be wavelength-dependent. We evaluated a patient with a long-standing history of light-induced petit mal seizures to determine if the seizures were triggered more effectively by a particular range of wavelengths and to determine whether this information could be used in the optometric management of such patients. METHODS: Flickering lights of different wavelengths but equal luminance were presented while the patient's electroencephalogram (EEG) and subjective reports were monitored. RESULTS: The EEG results were not significantly different for different wavelengths, but the patient reported that longer wavelength light induced stronger seizures more consistently. Based on these results we concluded that the patient might benefit from spectacles tinted to exclude transmission of red light. The patient was given 4 pairs of 85% transmission spectacles, which differed only in lens tint (red, yellow, green, and blue), to try over a period of time. The patient felt that the tinted lenses were not dark enough to decrease his seizures effectively and he has opted to wear standard sunglasses. CONCLUSIONS: We feel this case shows that patients with light-induced seizures can benefit from optometric consultation. Because the patient's subjective report identified the clearest wavelength effect, we feel that it is reasonable for the general practitioner to suggest deeply tinted lenses to reduce the frequency of seizures in these patients.     

Impaired biotin status in anticonvulsant therapy

In 264 epileptics undergoing long-term therapy with anticonvulsants, significantly reduced plasma biotin levels were found compared with a normal control group: 74% of the epileptics had biotin levels of 250 ng/L or less. In patients undergoing single-drug therapy, the mean plasma biotin levels for those treated with sodium valproate were higher than for those treated with phenytoin, primidone, or carbamazepine. The observed reduction in biotin levels might be a factor influencing the efficacy of these three anticonvulsants.     

Evaluation of skin irritancy of sodium lauryl sulphate: a comparative study between the replica method and visual evaluation

For 20 years, using the replica method, we have evaluated the skin irritancy of about 10,000 commercial products which come into contact with the skin. In this method, test substances are usually applied on the flexor side of the upper arm for 24 h by semi-open patch test. Subsequently, skin replicas are taken and skin irritancy is evaluated microscopically. In the semi-open patch test, test substances are not completely occluded as in the closed patch test. Thus, this method is less invasive than the closed patch test method to the tested subjects. In this study, we investigated the sensitivity of microscopic scoring (MS) of the replica and visual scoring (VS) of the skin. Sodium lauryl sulphate (SLS) at 0.02%, 0.05%, and 0.2% was applied on 20 subjects' upper arms, using closed and semi-open methods. In both the closed patch test and the semi-open patch test, the value of MS correlated with the concentration of SLS, while VS did not show such a clear correlation. In addition, we compared 2 clinical tests for skin irritancy which are commonly performed in Japan: VS of 48 h closed patch test reaction on the subjects' upper backs and MS of 24 h semi-open patch test reaction on the subjects' upper arms (replica method). MS on the upper arms resulted in a constant score, regardless of the location of application, while VS on the upper back produced results which differed widely depending on the location. Thus, the replica method is a useful clinical test for skin irritancy, because it is sensitive, reproducible and non-invasive.