Clinical Neuroscience

[Multiple aspects study of short term memory performance in two diagnostic groups of epileptic patients]

BARCS Gábor1, VITRAI József1, HALÁSZ Péter2

MARCH 20, 1996

Clinical Neuroscience - 1996;49(03-04)

[The short term verbal and the visuo-spatial memory performance of 37 temporal lobe, 30 idiopathic generalized epileptic patients, and 24 normal control individuals were studied by interactive computerized tests. The short term visuo-spatial memory performance of epileptic patients was basically determined by the Raven IQ and strongly influenced by the seizure frequency and sustained attention while the verbal memory performance seemed to be independent of these parameters. The verbal memory performance of temporal lobe epileptic patients on carbamazepine monotherapy was lower compared to the idiopathic generalized epileptic patients on valproate monotherapy and to the normal controls. The difference between the performance of temporal lobe epileptic patients and normal controls was statistically significant. The memory performance in the group of temporal lobe epileptics proved to be independent of the laterality of the affected side. Concerning the short term visuo-spatial memory, after the factors having influence on the memory were ruled out, there was no difference between the controls and patients. Memory performance was not influenced by the duration of the illness nor by the type of antiepileptics used. In a treatment resistant group of idiopathic generalized epileptic patients, without considering other factors having influences on the memory, the visuo-spatial memory performance was even lower than the performance of the temporal lobe epileptic patients.]


  1. Országos Pszichiátriai és Neurológiai Intézet
  2. Haynal Imre Egészségtudományi Egyetem Orvostovábbképző Kar, Neurológiai Tanszék, Budapest



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Clinical Neuroscience

[Use of subdural stips in presurgical evaluation of epileptic patients]

HALÁSZ Péter, PAPP László, VAJDA János, SÓLYOM András, CZIRJÁK Sándor

[The subdural strip-electrode technique was introduced in the eighties in the USA. An account is given here of the first Hungarian experience with this method using implantates developed by us. The properties of the electrodes and the use of the technique are described under chronic and intraoperative conditions. In 8 patients the strips were used to localize the pacemaker zone of the seizures in those cases where the scalp EEG and neuroimaging data were discordant. Two temporal, 4 frontal and 2 parietal lobe epileptic patients were studied. Sixty-six seizures were recorded and on 15 occasions the strips were used for intraoperative corticography. The chronically implanted electrodes provided safe conditions for recording and by means of these we obtained additional information in all the cases studied thereby contributing to the indication of surgery or in the rejection of a surgical solution. The mobility and flexibility of the strips make them an ideal tool for corticography. With the strips the invasivity of presurgical evaluation was reduced.]

Clinical Neuroscience

[Dysfunctional personality attitudes and depression amng adolescents suffering from migraine-type headache]

CSORBA János, FARKAS Viktor, MIHÁDÁK Katalin

[Authors compared a clinical sample of adolescent migraine patients (n=28) aequal in age mean sex ratio with a group of healthy control adolescents (n=68) to demonstrate some differential psychological characteristics of adolescents suffering from migraine. The Dysfunctional Attitude Scale (Burns) and Beck's Depression Inventory were used. The patient sample achieved an increased scores on Approval, Entitlement and Omnipotence scales as well as the group showed a greater total means of the DAS scale, but an unexpectedly lower level of Depressivity has been proved in the clinical sample. Both DAS variables and BDI characterize the two groups better, than clinical features, but besides sufficient sensitivity only moderate specificity was managed to achieve on classification by means of discriminant analysis. Migraneous adolescents do not suffer from depressivity, only gradual differences between the two samples have been found.]

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[Intracranial respiratory epithelial cysts: report of two cases]


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Clinical Neuroscience

Effects of valproate, carbamazepine and levetiracetam on Tp-e interval, Tp-e/QT and Tp-e/QTc ratio


Aim - To evaluate P-wave dispersion before and after antiepileptic drug (AED) treatment as well as to investigate the risk of ventricular repolarization using the Tpeak-Tend (Tp-e) interval and Tp-e/QT ratio in patients with epileptic disorder. Methods - A total of 63 patients receiving AED therapy and 35 healthy adults were included. ECG recordings were obtained before and 3 months after anti-epileptic treatment among patients with epilepsy. For both groups, Tp-e and Tp-e/QT ratio were measured using a 12-lead ECG device. Results - Tp-e interval, Tpe/QT and Tp-e/QTc ratios were found to be higher in the patient group than in the control group (p<0.05, for all), while QTmax ratio was significantly lower in the patient group. After 3 months of AED therapy, significant increases in QT max, QTc max, QTcd, Tp-e, Tp-e/QT, and Tp-e/QTc were found among the patients (p<0.05). When the arrhythmic effects of the drugs before and after treatment were compared, especially in the valproic acid group, there were significant increases in Tp-e interval, Tp-e/QT and Tp-e/QTc values after three months of treatment (p<0.05). Carbamazepine and levetiracetam groups were not statistically significant in terms of pre- and post-treatment values. Conclusions - It was concluded that an arrhythmogenic environment may be associated with the disease, and patients who received AED monotherapy may need to be followed up more closely for arrhythmia.

Clinical Neuroscience

Management of bone metabolism in epilepsy

UÇAN TOKUÇ Ezgi Firdevs , FATMA Genç, ABIDIN Erdal, YASEMIN Biçer Gömceli

Many systemic problems arise due to the side effects of antiepileptic drugs (AEDs) used in epilepsy patients. Among these adverse effects are low bone mineral density and increased fracture risk due to long-term AED use. Although various studies have supported this association with increased risk in recent years, the length of this process has not been precisely defined and there is no clear consensus on bone density scanning, intervals of screening, and the subject of calcium and vitamin D supplementation. In this study, in accordance with the most current recommendations, our applications and data, including the detection of possible bone mineralization disorders, treatment methods, and recommendations to prevent bone mineralization disorders, were evaluated in epilepsy patients who were followed up at our outpatient clinic. It was aimed to draw attention to the significance of management of bone metabolism carried out with appropriate protocols. Epilepsy patients were followed up at the Antalya Training and Research Hospital Department of Neurology, Epilepsy Outpatient Clinic who were at high risk for osteoporosis (use of valproic acid [VPA] and enzyme-inducing drugs, using any AED for over 5 years, and postmenopausal women) and were evaluated using a screening protocol. According to this protocol, a total of 190 patients suspected of osteoporosis risk were retrospectively evaluated. Four patients were excluded from the study due to secondary osteoporosis. Of the 186 patients who were included in the study, 97 (52.2%) were women and 89 (47.8%) were men. Prevalence of low bone mineral density (BMD) was 42%, in which osteoporosis was detected in 11.8% and osteopenia in 30.6% of the patients. Osteoporosis rate was higher at the young age group (18-45) and this difference was statistically significant (p=0.018). There was no significant difference between male and female sexes according to osteoporosis and osteopenia rates. Patients receiving polytherapy had higher osteoporosis rate and lower BMD compared to patients receiving monotherapy. Comparison of separate drug groups according to osteoporosis rate revealed that osteoporosis rate was highest in patient groups using VPA+ carbamazepine (CBZ) (29.4%) and VPA polytherapy (19.4%). Total of osteopenia and osteoporosis, or low BMD, was highest in VPA polytherapy (VPA+ non-enzyme-inducing AED [NEID]) and CBZ polytherapy (CBZ+NEID) groups, with rates of 58.3% and 55.1%, respectively. In addition, there was no significant difference between drug groups according to bone metabolism markers, vitamin D levels, and osteopenia-osteoporosis rates. Assuming bone health will be affected at an early age in epilepsy patients, providing lifestyle and diet recommendations, avoiding polytherapy including VPA and CBZ when possible, and evaluating bone metabolism at regular intervals are actions that should be applied in routine practice.

Clinical Neuroscience

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Clinical Neuroscience

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