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Public education and epilepsy
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COMPARISON OF METHODS NUMBERS IN PATIENTS WITH LATERAL SCLEROSIS (ALS).
OF ASSESSING PROGRESSING
MOTOR UNIT AMYOTROPHIC
J.R. Dnuhe (Mayo Clinic, Rochester.
MN, U.S.A.)
Ten patients with classical AL5 were tested sequentially with standard elcctrophysiologtc tests and with three estimates of number of motor units in selected muscles. The latter included: 1. Semiquantitative estimates of recruitment of voluntarily activated motor unit potentials on needle electromyography. 2. Calculations of motor unit numbers from the size of increments with minimal stimulation and the size of the supramaximal response. 3. Estimates of numbers of motor units from the statistical variance occurring spontaneously with stimulation at S15% of supramaximal. E.ach of the three methods showed consistent, comparable reductions in numbers of motor units that were reproducible by a single examiner. Estimates of number of units in clinically involved muscles were all less than half the normal number, and comparably reduced with each of the methods. They ranged from 3-6.5 in hand muscles. Decreases in the number of motor units over periods of 3-24 months varied widely from patient to patient with some showing no significant change. and others losing over half of the units. The rate of loss of motor units varied from O-10 per month. Similar values were obtained with both methods and correlated with the semiquantitative findings of recruitment on needle examination. They were less well correlated with extent of motor unit potential size changes or density of fibrillation potentials. Motor unit number estimates should be considered as a quantitative measure of the effectiveness of treatment trials for motor neuron diseases.
HOW USEFUL ARE: POLYGRAPHIC SLEEP EVALUATING; THE EFFECTS OF HYPSOTICS. A.(?. De&r& (Epilepsy
I,. Kho, M.A.P.M.
Centre
PARkhlETERS
IN
dc Leijer, F. Ruwe
Kempenhaeghe.
M.E. De Quesadu (Clinica
ANALYSIS
Marhm,
del Adolescente,
PUBLIC
EDUCATION
M.D. Dins, D.M. Mayor.
AND EPILEPSY. T.1I.B. Pinto and M. Albuquerque
(Brazilian Epilepsy Association) A questionnaire was designed to obtain information on personal attitudes and knowledge about epilepsy. Primary and high school teachers and professors (medical and non-medical areas) participated. When asked whether school children with epilepsy have any particular problem, 92.3% of the sample did not identify problems. 17.9% believed in hereditary character and 95% answered that the seizures are the result of cerebral hyperexcitability. 100% of respondents did not believe in contamination. 91% would like to learn about epilepsies. 85.9% of respondents considered epilepsy rncurable and 71.4% of professors (medical area) had the same opinion. Of the total. SS.l%> did not know how to look after epileptics during a tonic-clonic seizure. 52.4% of professors (medical area) believed that epilepsy was something like “dysrhythmia”. and 13% of them placed objects on a patient’s mouth during a seizure. We condlude that the professors (medical area) dtd not know enough about epilepsy. It is essential to educate medical practitioners, teachers and professors to convey a positive attitude towards epilepsy in order to improve the quality of life and medical treatment for patients.
Heeze. The Netherlands)
Long-term polygraphic recording is a method which is increasingly applied to investigate complaints related to sleep and sleep-wakefulness rhythms and to evaluate the effects of hypnotics. The most prescribed hypnotics today belong to the category of benzodiazepines (BDZ). Of these drugs one may expect the following: 1) Shortening of sleep latencies; 2) Less frequent awakenings during the night: 3) Decrease of NREM 1 sleep; 4) Increase of NREM 2 sleep: 5) Decrease of NREM 3-4 sleep:; 6) Prolongation of REM latency. On the basis of our own investigations, we assessed which of these parameters are the most sensitive in differentiating a BDZ from a placebo and a non-BDZ compound, even after a single intake. Considering the changes in these parameters following long-term intake (4 to 6 weeks) is also important in relation to subjective evaluation of sleep.
NEUROMETRIC ADOLESCENTS.
(SCII) in the age range 13-18 yrs were compared with normative data (NS). Data collection and analysis was performed by the digital l
OF
PSYCHOTIC
J. Aquino Playa, IIavana,
CHILDREN
Cias and E. Guticrrez
AND
Bare
Cuba)
CEG neurometric analysis of 20 patients with organic psychosis (OP) caused by mild tonsilitis and adenoid infections and of 20 schizophrenics
BRAIN VIAPPING G.F. Diaz (Institute
STUDIES
IN EPILEITIC
P.4TIIJNTS.
and 0. Hernandez of Neurology
and Neurosurgery,
Ilavana,
Cuba)
Conventional and quantitative EIiG studies (CEEG. QEEG) were performed on 20 epileptic patients with different types of seizures, half of them having normal CEEG but subsequent abnormal (paroxysmal) nap EEG studies (NEEG). Abnormalities in QEEG analysis were found in all patients with abnormal CEEGs and in 80% of patients with normal CEEGs. Close correlation was evident between location of QEEG and CEEG abnormalities regarding the focalization of both paroxysmal activity and background EEG slow activity. In epileptic patients having normal CEEGs, correlation between QEEG and NEEG was similarly evident, suggesting a possible close relationship between paroxysmal activity (PA) and appearance of focal QEEG abnormalities even though PA was not present while recording QEEG studies in such patients. It must be stressed that the QEEG methods are based upon spectral methods that are apparently insensitive to sharp transients. Accuracy in differentiating these epileptic patients from normal and the correlation between focal QEEG and CEEG (or NEEG) abnormalities in patients is also computed by means of ROC cutves.
COMPARISON OF METHODS NUMBERS IN PATIENTS WITH LATERAL SCLEROSIS (ALS).
OF ASSESSING PROGRESSING
MOTOR UNIT AMYOTROPHIC
J.R. Dnuhe (Mayo Clinic, Rochester.
MN, U.S.A.)
Ten patients with classical AL5 were tested sequentially with standard elcctrophysiologtc tests and with three estimates of number of motor units in selected muscles. The latter included: 1. Semiquantitative estimates of recruitment of voluntarily activated motor unit potentials on needle electromyography. 2. Calculations of motor unit numbers from the size of increments with minimal stimulation and the size of the supramaximal response. 3. Estimates of numbers of motor units from the statistical variance occurring spontaneously with stimulation at S15% of supramaximal. E.ach of the three methods showed consistent, comparable reductions in numbers of motor units that were reproducible by a single examiner. Estimates of number of units in clinically involved muscles were all less than half the normal number, and comparably reduced with each of the methods. They ranged from 3-6.5 in hand muscles. Decreases in the number of motor units over periods of 3-24 months varied widely from patient to patient with some showing no significant change. and others losing over half of the units. The rate of loss of motor units varied from O-10 per month. Similar values were obtained with both methods and correlated with the semiquantitative findings of recruitment on needle examination. They were less well correlated with extent of motor unit potential size changes or density of fibrillation potentials. Motor unit number estimates should be considered as a quantitative measure of the effectiveness of treatment trials for motor neuron diseases.
HOW USEFUL ARE: POLYGRAPHIC SLEEP EVALUATING; THE EFFECTS OF HYPSOTICS. A.(?. De&r& (Epilepsy
I,. Kho, M.A.P.M.
Centre
PARkhlETERS
IN
dc Leijer, F. Ruwe
Kempenhaeghe.
M.E. De Quesadu (Clinica
ANALYSIS
Marhm,
del Adolescente,
PUBLIC
EDUCATION
M.D. Dins, D.M. Mayor.
AND EPILEPSY. T.1I.B. Pinto and M. Albuquerque
(Brazilian Epilepsy Association) A questionnaire was designed to obtain information on personal attitudes and knowledge about epilepsy. Primary and high school teachers and professors (medical and non-medical areas) participated. When asked whether school children with epilepsy have any particular problem, 92.3% of the sample did not identify problems. 17.9% believed in hereditary character and 95% answered that the seizures are the result of cerebral hyperexcitability. 100% of respondents did not believe in contamination. 91% would like to learn about epilepsies. 85.9% of respondents considered epilepsy rncurable and 71.4% of professors (medical area) had the same opinion. Of the total. SS.l%> did not know how to look after epileptics during a tonic-clonic seizure. 52.4% of professors (medical area) believed that epilepsy was something like “dysrhythmia”. and 13% of them placed objects on a patient’s mouth during a seizure. We condlude that the professors (medical area) dtd not know enough about epilepsy. It is essential to educate medical practitioners, teachers and professors to convey a positive attitude towards epilepsy in order to improve the quality of life and medical treatment for patients.
Heeze. The Netherlands)
Long-term polygraphic recording is a method which is increasingly applied to investigate complaints related to sleep and sleep-wakefulness rhythms and to evaluate the effects of hypnotics. The most prescribed hypnotics today belong to the category of benzodiazepines (BDZ). Of these drugs one may expect the following: 1) Shortening of sleep latencies; 2) Less frequent awakenings during the night: 3) Decrease of NREM 1 sleep; 4) Increase of NREM 2 sleep: 5) Decrease of NREM 3-4 sleep:; 6) Prolongation of REM latency. On the basis of our own investigations, we assessed which of these parameters are the most sensitive in differentiating a BDZ from a placebo and a non-BDZ compound, even after a single intake. Considering the changes in these parameters following long-term intake (4 to 6 weeks) is also important in relation to subjective evaluation of sleep.
NEUROMETRIC ADOLESCENTS.
(SCII) in the age range 13-18 yrs were compared with normative data (NS). Data collection and analysis was performed by the digital l
OF
PSYCHOTIC
J. Aquino Playa, IIavana,
CHILDREN
Cias and E. Guticrrez
AND
Bare
Cuba)
CEG neurometric analysis of 20 patients with organic psychosis (OP) caused by mild tonsilitis and adenoid infections and of 20 schizophrenics
BRAIN VIAPPING G.F. Diaz (Institute
STUDIES
IN EPILEITIC
P.4TIIJNTS.
and 0. Hernandez of Neurology
and Neurosurgery,
Ilavana,
Cuba)
Conventional and quantitative EIiG studies (CEEG. QEEG) were performed on 20 epileptic patients with different types of seizures, half of them having normal CEEG but subsequent abnormal (paroxysmal) nap EEG studies (NEEG). Abnormalities in QEEG analysis were found in all patients with abnormal CEEGs and in 80% of patients with normal CEEGs. Close correlation was evident between location of QEEG and CEEG abnormalities regarding the focalization of both paroxysmal activity and background EEG slow activity. In epileptic patients having normal CEEGs, correlation between QEEG and NEEG was similarly evident, suggesting a possible close relationship between paroxysmal activity (PA) and appearance of focal QEEG abnormalities even though PA was not present while recording QEEG studies in such patients. It must be stressed that the QEEG methods are based upon spectral methods that are apparently insensitive to sharp transients. Accuracy in differentiating these epileptic patients from normal and the correlation between focal QEEG and CEEG (or NEEG) abnormalities in patients is also computed by means of ROC cutves.