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Epilepsy and porphyria: Clinical observations
$216 various reasons, and secondly, if given, when should they be withdrawn? Using the London Hospital EEG file it has been possible to obtain answers to both these questions on the basis of a trial in which 34 patients with a known susceptibility to epilepsy was about 20-32%. Administration of anti-convulsants showed a decreased incidence of a seizure disorder, namely, 5.9% with a follow up for an average of 6 years. The EEG in this group was assessed in relation to the a m o u n t of 'epileptic activity' present, and indicated the likelihood of clinical manifestations that a seizure would occur. The same criteria were used in a much larger group of neurosurgical patients at risk, 349, and most not only showed the importance of anti-convulsants, but the time at which they could be withdrawn. In most instances this was 'safe' at 2 - 3 years after craniotomy, but in others much longer periods of routine drug administration were required. Hence, in spite of the m a n y other reports to the contrary, the EEG is a useful adjunct in the management of neurosurgical patients.
P41.09 EEG D I A G N O S I S O F H Y S T E R I C A L ( P S E U D O ) S E I Z U R E S - USE O F SALINE S U G G E S T I O N T E S T IN 100 CASES. C.G. Suter (Richmond, USA) EEG monitoring during an attack allows the clear differential between hysterical (pseudo) and 'real' seizures. This is easily accomplished by inducing an attack with suggestion and stopping the attack with suggestion associated with the I.V, injection of normal saline. Experience with this technique in 100 cases is outlined and association of 'real' seizures and normal and abnormal interictal records described. EEG artifacts falsely suggesting real seizures are presented. In 100 patients at least 75% had hysterical (pseudo) seizures alone.
P41.10 EPILEPSY SERVATIONS.
AND PORPHYRIA:
CLINICAL OB-
I. Somogyi, I. Durko, V. Csik, G. Dibo and 72 Jhrdhnhitzy
(1982,1983) that, in the development of epilepsy, the porphyrin metabolism disturbance plays the primary role, and alcohol the secondary role in the induction of porphyria. In our hypothesis we are taking into account the close correlation between tryptophan and the haem metabolism of the nervous system. In our cases the porphyrinogenic effect of anti-epileptics can be excluded.
P41.11 G E O G R A P H I C A L AND S E A S O N A L VARIATIONS IN T H E INCIDENCE O F EPILEPTIC P H O T O S E N S I T I V ITY. M.A. Danesi (London, U K ) This study investigated the influence of environmental factors on epileptic photosensitivity by: (1) comparing the incidence of photoparoxysmal discharges in the EEGs of epileptic patients living in two distinct geographical environments: Lagos in Nigeria (tropical environment) and London in U K (temperate environment); and (2) comparing the incidence of the same discharges in British epileptic patients seen in summer with those seen in winter. About 2,856 epileptics seen at the National Hospital, Queen Square, London over a period of four years were compared with 976 patients seen at the Lagos University Teaching Hospital over the same period. 738 British epileptic patients seen in summer were compared with 560 patients seen in winter. The result showed a significantly lower incidence of photosensitivity in Nigerian epileptics (0.8%) compared with British epileptics (4.6%) and amongst British epileptics, a lower incidence in summer (1.8%) compared with winter (8.6%). This seasonal difference was consistently observed yearly, over the four year period. The monthly incidence of photosensitivity showed the highest incidence in February decreasing to the lowest incidence in August and subsequently rising monthly, thereafter. Conclusion: this study showed that photosensitivity is relatively rare in the tropics in summer, suggesting an association between environmental situations with abundant sunshine and low incidences of epileptic photosensitivity.
P41.12 IS S U N S H I N E P R O T E C T I V E IN P H O T O S E N S I TIVE EPILEPSY?
(Szeged, Hungary) 15 male epilepsy cases are reported. In these patients, the background of alcoholism was documented after clarification of the pathological nature of the porphyrin metabolism. In the EEG were epileptiform irritative activity in 8 cases, slow-wave activity in 4 cases and no pathological signs in 3 cases. Neurological examinations demonstrated the signs of mixed central and peripheral lesions in 10 cases. Blood, urine and faeces examinations are indicative of porphyria. Our data appear to support our earlier assumption
D.F. Scott, P.F. Furlong, Adrienne M. Moffett and G.F.A. Harding (London and Aston, U K ) Recently Danesi, (Electroenceph. clin. Neurophysiol. 1985, in press) suggested that in summertime photosensitive epilepsy was less c o m m o n in temperate climates than in winter. To examine this The London Hospital Computer File (Scott and Prior, 1981) was searched for patients with the appropriate
P41.09 EEG D I A G N O S I S O F H Y S T E R I C A L ( P S E U D O ) S E I Z U R E S - USE O F SALINE S U G G E S T I O N T E S T IN 100 CASES. C.G. Suter (Richmond, USA) EEG monitoring during an attack allows the clear differential between hysterical (pseudo) and 'real' seizures. This is easily accomplished by inducing an attack with suggestion and stopping the attack with suggestion associated with the I.V, injection of normal saline. Experience with this technique in 100 cases is outlined and association of 'real' seizures and normal and abnormal interictal records described. EEG artifacts falsely suggesting real seizures are presented. In 100 patients at least 75% had hysterical (pseudo) seizures alone.
P41.10 EPILEPSY SERVATIONS.
AND PORPHYRIA:
CLINICAL OB-
I. Somogyi, I. Durko, V. Csik, G. Dibo and 72 Jhrdhnhitzy
(1982,1983) that, in the development of epilepsy, the porphyrin metabolism disturbance plays the primary role, and alcohol the secondary role in the induction of porphyria. In our hypothesis we are taking into account the close correlation between tryptophan and the haem metabolism of the nervous system. In our cases the porphyrinogenic effect of anti-epileptics can be excluded.
P41.11 G E O G R A P H I C A L AND S E A S O N A L VARIATIONS IN T H E INCIDENCE O F EPILEPTIC P H O T O S E N S I T I V ITY. M.A. Danesi (London, U K ) This study investigated the influence of environmental factors on epileptic photosensitivity by: (1) comparing the incidence of photoparoxysmal discharges in the EEGs of epileptic patients living in two distinct geographical environments: Lagos in Nigeria (tropical environment) and London in U K (temperate environment); and (2) comparing the incidence of the same discharges in British epileptic patients seen in summer with those seen in winter. About 2,856 epileptics seen at the National Hospital, Queen Square, London over a period of four years were compared with 976 patients seen at the Lagos University Teaching Hospital over the same period. 738 British epileptic patients seen in summer were compared with 560 patients seen in winter. The result showed a significantly lower incidence of photosensitivity in Nigerian epileptics (0.8%) compared with British epileptics (4.6%) and amongst British epileptics, a lower incidence in summer (1.8%) compared with winter (8.6%). This seasonal difference was consistently observed yearly, over the four year period. The monthly incidence of photosensitivity showed the highest incidence in February decreasing to the lowest incidence in August and subsequently rising monthly, thereafter. Conclusion: this study showed that photosensitivity is relatively rare in the tropics in summer, suggesting an association between environmental situations with abundant sunshine and low incidences of epileptic photosensitivity.
P41.12 IS S U N S H I N E P R O T E C T I V E IN P H O T O S E N S I TIVE EPILEPSY?
(Szeged, Hungary) 15 male epilepsy cases are reported. In these patients, the background of alcoholism was documented after clarification of the pathological nature of the porphyrin metabolism. In the EEG were epileptiform irritative activity in 8 cases, slow-wave activity in 4 cases and no pathological signs in 3 cases. Neurological examinations demonstrated the signs of mixed central and peripheral lesions in 10 cases. Blood, urine and faeces examinations are indicative of porphyria. Our data appear to support our earlier assumption
D.F. Scott, P.F. Furlong, Adrienne M. Moffett and G.F.A. Harding (London and Aston, U K ) Recently Danesi, (Electroenceph. clin. Neurophysiol. 1985, in press) suggested that in summertime photosensitive epilepsy was less c o m m o n in temperate climates than in winter. To examine this The London Hospital Computer File (Scott and Prior, 1981) was searched for patients with the appropriate