摘要:

ABSTRACT28 MS patients were studied at least 5 times for lymphocyte blast transformation responses to several mitogens (PHA, Con, PWM) and specific antigens (PPD, herpes simplex, measles, mumps, rubella), the mean duration of the follow‐up being 15.3 months. Comparison of responses during remissions, exacerbations and ACTH treatment revealed no straight‐forward association between the strength of response and clnical disease activity. Mitogen responses did not differ among various disease phases, but the PPD response was significantly lower during exacerbations than during remissions and still lower during ACTH treatment (P<0.05, Wilcoxon paired test). In responses to viral antigens, there was the same trend as in the PPD response. However, there were great individual differences in the behaviour of all antigen and mitogen induced lymphocyte responses.As a group, MS patients also showed more changes in their PHA mitogen responses during the follow‐up than 8 control subjects followed similarly (P<0.005, F‐test). The variation coefficient of the PHA response was also correlated with the maximal difference in the Fog neurologic deficit scale during the follow‐up time (r = 0.460, P<0.05). However, patients with greatest clinical changes most often also received ACTH treatment, which may affect the results.The follow‐up results of individual patients revealed that some had quite regular patterns of decreasing responses during disease relapses, whereas others had more irregular wide fluctuations o

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1983.tb04808.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1983.tb01510.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1983.tb01529.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1983.tb01530.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

ABSTRACTEssential in the diagnosis of epilepsy are repeated seizures due to discharge of electrical activity in the brain neurons, occurring without massive provocation. It is important to differentiate between epileptic seizures from syncopal reactions, cardiac dysrhythmias, vascular causes, metabolic disturbances, and psychogenic seizures. The type of seizure should always be established. It is of utmost importance to find the primary etiology of the seizure and to clarify the role of predisposing factors and the risk for seizure recurrence.Numerous important technical advances in the last few years have been of great benefit in the examination of patients with suspected epilepsy. It is worth keeping in mind, however, that the diagnosis of epilepsy is a clinical diagnosis, and it is not proper to speak of epilepsy until the patient has had two or more epileptic seizures within a relatively short interval and without massive provocation.

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1983.tb01531.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

ABSTRACTCalcium metabolism was examined in 30 adult epileptic outpatients on carbamazepine monotherapy. The patients had a normal bone mass, evaluated both on the forearm (100 ± 13 of normal) and on the total skeleton (102 ± 15), and normal serum concentrations of 250HD. The serum calcium was decreased (P<0.001) and the serum alkaline phosphatase increased (P<0.001). The clinical significance of our study is that monotherapy with carbamazepine does not have the side effects on bone metabolism known as “anticonvulsant osteomalacia”. Our results further question the connection between liver enzyme induction and anticonvulsant osteomalacia, since carbamazepine possesses the same potency of liver enzyme induction as phenytoin. Further studies on epileptic outpatients will be necessary in order to elucidate the connection between treatment with anticonvulsant drugs and anticonvulsant osteoma

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1983.tb04809.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

ABSTRACTThe rational use of antiepileptic drugs requires the consideration of their pharmacokinetics, which may be influenced by the physiological and pathological factors. Pharmacokinetic intractions between antiepileptic drugs may lead to considerable fluctuation in plasma drug concentration, and monotherapy is often preferable.The absorption of phenytoin depends on pharmaceutical formulation. Phenytoin is highly bound to plasma proteins, thus the changes in the unbound fraction are of clinical significance. The saturation kinetics of its metabolism and drug interactions have further consequences. Carbamazepine is well absorbed and largely metabolized. Due to the autoinduction its half‐life shortens in chronic administration. Valproate is highly, but variably bound to plasma proteins. It is eliminated mainly by metabolism. Due to the long half‐life of phenobarbital its plasma concentrations change slowly, and time to the steady‐state may be up to 30 days, if no loading dose is given. Primidone is partly metabolized to phenobarbital, and at steady‐state plasma concentration of phenobarbital often exceeds that of primidone. Diazepam, clonazepam and nitrazepam are largely bound to plasma proteins and extensively metabolized with the half‐lives of 20 to

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1983.tb01532.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

ABSTRACT —Levodopa treatment improves significantly not only the parkinsonian disability but also the mortality rate. However, during long‐term levodopa treatment the therapeutic benefit gradually declines. Furthermore, most cognitive skills improve initially, but long‐term levodopa treatment is associated with declining intellectual capacity and dementia.In patients on long‐term levodopa treatment there seems to be a low threshold for certain clinical side‐effects, especially postural hypotension, psychiatric disturbances and various types of fluctuations in disability. Low age at onset of Parkinson's disease, and at the commencement of levodopa therapy, the duration of levodopa treatment and a high dose of levodopa seem to be significant risk factors for the development of response fluctuations, but not the pretreatment duration of Parkinson's disease nor the disability of the patients.A readjustment of the levodopa dosage, and as an adjuvant drug treatment, deprenyl, a specific inhibitor of MAO type B, or a direct‐acting dopamine agonist may prove helpful in the management of fluctuations in disability. It is important, moreover, to try to prevent these phenomena by taking into account the predictive risk factors of response fluctuations in the treatment strategy of Parkinso

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1983.tb01513.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

ABSTRACTAll cases of motor neuron disease (MND), encompassing amyotrophic lateral sclerosis (ALS), progressive bulbar paralysis (PBP) and progressive spinal muscular atrophy (PSMA), in northern Sweden, diagnosed between 1969‐1980 have been analysed. 128 cases were found, corresponding to an average annual incidence rate of 1.67 per 100,000. The prevalence on December 31, 1980 was 4.8 per 100,000. Age‐specific incidence rates were higher in the high age groups with a maximum at 60‐64 years for males, at 70‐74 years for females and at 65‐69 years for the sexes combined. The median age at onset was 61 years.Clustering was not found in mining districts and overrepresentation of miners and stone treaters was not observed.Minor differences in incidence rates, as measured by the standardized morbidity ratio, SMR, were found between the inland, coastal and mountain areas.The median survival time after onset of disease was 32 months for ALS, 30 months for PBP and 70 months for PSMA. The combined survival rate for all MND cases was 28% after 5 years and 15% after 10 years.The male to female ratio was 1.1:1, and 4.7% were famil

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1983.tb04810.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

ABSTRACT —As we have earlier shown, sudden extreme changes in disease severity are a characteristic feature of Parkinson's disease. These variations take two main forms, those natural to the disease and those occurring as a result of treatment. Treatment‐related response variations can sometimes be attributed to the known pharmacokinetic properties of anti‐parkinsonian drugs and, in particular, levodopa. These responses are time‐dependent. In contrast, other types of response variation may be unpredictable in time, and are at present rarely amenable to treatment. Identification of the cause of variation is necessary for the management of parkinsonism, and particularly for the successful use of d

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1983.tb01514.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY