ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1996.tb00365.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

This state of the art document is the result of the conference held in Stockholm on March 9–10, 1995, initiated by the Swedish Medical Research Council.The conference brought together researchers from basic science and clinic to different disciplines. Response to questions was given in small groups and the answers were presented and dicussed with all the participants. The final consensus was formulated in this larger group and comprises the state of the art documen

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1996.tb00366.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1996.tb06048.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Introduction– The aim of this research was to evaluate changes in cognitive performances, mood and quality of life in drug‐resistant epileptic patients, after the introduction of Vigabatrin (VGB) as additional treatment.Material and methods– A four‐step evaluation was carried out in two groups of 20 patients each, randomly assigned to VGB or placebo treatment. A battery of neuropsychological tests investigating attention, memory and adaptive abilities, associated with inventories concerning depression, quality of life and the concern of families upon patient behaviour, were utilised. For each subject, four evaluations were performed, two before and two after VGB/placebo administration.Results– No relevant side‐effects regarding cognition and behaviour were detected in the VGB group. The intra‐group comparison between pre‐ and post‐treatment phases showed a slight improvement in cognitive performances of VGB patients and a positive change in their overall psychological status. The inter‐group comparison confirmed the selective improvement occurring in the trend of a few neuropsychological test scores in the VGB group.Conclusion– Such results help to reject the hypothesis that the addition of VGB to the current antiepileptic treatment may affect cognitive perfo

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1996.tb00032.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

407 patients (248 men, 159 women) of epilepsy attending the neurology clinic were evaluated to find out the profile of epilepsy, cost‐effectiveness of various investigations, therapeutic regimens and efficacy of referring physicians in a developing country. At the time of onset of seizures 67.2% of patients were in the second and third decade. Generalised tonic clonic seizures were the commonest seizure type seen. Specific aetiology was established in 20.8% cases only. Neurocysticercosis was the commonest cause observed. The main source of referral (50.1%) was general practitioners. Referral diagnosis was incomplete in 52.8% of the cases. Investigations did not alter the diagnosis in 62.5% cases. The EEG was useful in the management of 15.1% cases of epilepsy. The skull x‐ray and chest x‐ray were abnormal in 1.7% and 2% cases respectively. CT scan revealed abnormality in 39.4% cases. Most of the patients were treated with monotherapy. Phenytoin, phenobarbitone and carbamazepine were the common drug used. Out of 246 cases who were started on anticonvulsant therapy prior to referral, the choice of drug was wrong in 78 (31.7%) cases and dose was inappropriate in 121 (49.2%) cases. It was concluded that most important factor for cost effective management of epilepsy is proper clinical evaluation and education of general physicians in this dire

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1996.tb00033.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Dementia is a descriptive term derived from the Latin root de mens, indicating an observable decline in mental abilities. It is an acquired clinical syndrome characterised by deterioration of mental functioning in its cognitive, emotional and conative aspects (1). The concept is comprehensive with several different clinical profiles and courses. The diagnosis of dementia implies that several mental faculties are involved and exclude isolated neuropsychiatrie disturbances such as amnesia and aphasia which occur with focal brain lesions. Description and classification of dementia conditions have however to deal with the problem that the word “dementia“ might have different meanings in different contexts (2). It might denote a clinical syndrome irrespective of etiology, but also imply that the etiology of this syndrome is brain dysfunction (3, 4). Moreover, the term dementia is sometimes used in a wider sense to describe the underlying brain disease from its early subtle manifestations to advanced stages of severe deterioration. By definition this deterioration previously was progressive and irreversible with little hope for the patient. Clinical experience however has changed our views, and it is now accepted that the course of dementia can be progressive, static or remittent

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1996.tb00367.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Single‐pulse transcranial magnetic stimulation (s‐TMS) with recording of motor evoked potentials (MEPs) from thenar muscles of both hands was performed on 84 patients with cryptogenic partial epilepsy and 50 healthy controls. We analyzed the cortical latency (CL), central conduction time (CCT), and threshold intensity (TI) required to elicit liminal MEPs at rest. In the patients, CL and CCT were normal, but TI was significantly higher than in the controls. Of the 84 patients, 65 were taking one or more antiepileptic drugs and 19 were untreated. The untreated patients had a significantly lower TI than the treated patients. In the treated patients, the TI increase paralleled the number of drugs taken. Additionally, in 2 subgroups of patients undergoing major modifications of antiepileptic treatment, TI dropped after partial withdrawl of medication and increased following the commencement of therapy. The results suggest that anticonvulsants depress the excitability of human motor pathways in epileptic subje

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1996.tb00034.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Alzheimer's disease (AD) is characterised neuropathologically by the accumulation of neuritic plaques and neurofibrillary tangles as well as by cerebrovascular amyloid deposition and neuronal cell loss. The major component of neuritic plaques and cerebrovascular amyloid is a 40–42 amino acid peptide termed β‐amyloid, derived as a proteolytic fragment from the large amyloid precursor protein (APP) (1, 2), a membrane‐bound protein expressed in most tissues. The last few years have seen considerable advances in understanding the pathogenesis of Alzheimer's disease through genetic studies. The importance of the β‐amyloid peptide in the pathogenesis of AD has been strengthened by the identification of pathogenic mutations in the APP gene on chromoso

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1996.tb00368.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Frontal lobe degenerative dementias, the second largest degenerative dementia group after Alzheimer's disease, is dominated by frontal lobe degeneration of non‐Alzheimer type. It is classified in a group also containing Pick's disease, progressive aphasia and dementia in motor neuron disease. Frontal lobe degeneration of non‐Alzheimer type is clinically marked by frontal lobe symptoms and frontotemporal reduction of blood flow. From a histopathological point of view it is characterized by gliosis, microvacuolation, neuronal atrophy‐loss and 40–50% loss of synapses in three superficial cortical laminae of the frontal convexity and anterior temporal cortex, while the deeper laminae are little or not changed. The structural changes of Alzheimer's disease including amyloid, Levy body dementia and Pick's disease are entirely lacking. A strong heredity points to a genetic cause as yet un

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1996.tb00369.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

This review concerns the fundamental cerebral lesions in cases of vascular dementia. Extracerebral vascular alterations are dominated by atherosclerosis with or without thrombosis. In addition, occlusion of extracerebral arteries can be induced by thrombo‐embolism and in rare cases by other vascular diseases, chiefly arteritis. Intracerebral microangiopathies are usually of arteriolosclerotic or hyalinotic types in which there is degeneration of smooth muscle cells of the media and deposition of components of extracellular matrix, chiefly collagens. Ageing, chronic hypertension, hyperlipidemias and diabetes are important factors inducing vascular lesions. The vascular lesions, often combined with systemic factors, may produce various ischemic and edematous alterations of the brain parenchyma. Occlusion and obliteration of arteries (macroangiopathy) are associated with large infarcts, whereas microangiopathy may cause lacunar infarcts and some forms of white matter degeneration. Cases of vascular dementia usually present many types of lesions in the brain parenchyma and its arterial supply. The extent and location of the injuries differ considerably from case to case. Location o(f the lesions, volume of destroyed tissue, multiplicity and bilateral occurrence are most important parameters underlying the clinical manifestations in vascular dementia. A strategic location of a small injury is in some cases of particular importanc

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1996.tb00370.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY