Lege Artis Medicinae

[Guidelines for the surgical treatment of epilepsy]

ANTAL János

AUGUST 28, 1991

Lege Artis Medicinae - 1991;1(14)

[Epilepsy is a common disease. The American of the American population will experience a seizure at least once in their lifetime. Most of them have only one or a few seizures and never have another. About 70% of people with recurrent seizures can be treated satisfactorily with antiepileptic drugs. Every year, 150 000 Americans develop epilepsy, 10-20% of whom cannot be controlled with medication. Many patients and family members have to live with a chronic disease that diminishes the quality of life for all.]

COMMENTS

0 comments

Further articles in this publication

Lege Artis Medicinae

[Laparoscopic surgery]

ANTAL András, BÁTFAI László, EZER Péter

[In the recent years abdominal surgery has developed quickly. Laparoscopic operating procedures have spread worldwide. These techniques have reached Hungary as well, though there are only few articles in this topic. Since last December - date of the first laparoscopic cholecystectomy – more than 200 operations have been done, among them the first appendectomy. These procedures are less troublesome for the patients with better cosmetic results, and the shorter period of hospitalisation and unability for work make economical advantages. First, the technical instruments and their usage, then personal coditions and the preparation programme are described. In the second part the usage of the new technique is summarized in cholecystectomy as well as in appendectomy. ]

Lege Artis Medicinae

[Report of the American Society of Gastrointestinal Endoscopic Surgeons Postgraduate Course and Scientific Meeting]

DUBECZ Sándor

[This year's congress of the Society of American Gastrointestinal Endoscopic Surgeons (SAGES) was held in Monterey, California. As a fellow of the Department of Gastroenterology at the University of Southern California, I was able to attend the congress with the support of Dr. Berci, Professor of Surgery at Cedars-Sinai Hospital.]

Lege Artis Medicinae

[Quo vadis chirurgia biliaris?]

SÁNDOR József, IHÁSZ Mihály

[Mankind has suffered from the agony of gallstones for thousands of years. Until the second half of the last century, there was practically no cure, the only relief being spontaneous internal and external fistulas in the midst of great pain.]

Lege Artis Medicinae

[Renal cell carcinoma in a horseshoe kidney treated with radical nephrectomy]

SZENTGYÖRGYI Ervin, KONDÁS József, KONDÉR Gyula

[A horseshoe kidney is diagnosed usually after the onset of its complication or the symptoms caused by an arising tumor from it. A tumour was diagnosed in the right half of the horseshoe kidney in a 68 year old female patient by excretory urography, ultrasound examination and renovasography. The tumour was removed by radical nephrectomy. The kidney was exposed through a horizontal abdominal approach. Special attention was given to the separate renal arteries supplying the right half of the horseshoe kidney and to the resection of the isthmus and also regional lymphadenectomy. In the diagnosis of a horseshoe kidney excretion urography had exclusively been used earlier but nowadays ultrasound is playing an increasingly important role. Reno vasography is usually needed only before resection or nephrectomy. The appropriate treatment of a horseshoe kidney tumour - in case of a well functioning contralateral kidney - is radical ablastic tumour nephrectomy including regional lymphadenectomy. ]

Lege Artis Medicinae

[Recommended principles and strategies for pre-surgical evaluation and surgical resolution of epilepsy]

HALÁSZ Péter

[I. General principles before surgical treatment of epilepsy; II. The surgical investigation process; III. Indications for surgery]

All articles in the issue

Related contents

Clinical Neuroscience

Evaluation of the effectiveness of transforaminal epidural steroid injection in far lateral lumbar disc herniations

EVRAN Sevket, KATAR Salim

Far lateral lumbar disc herniations (FLDH) consist approximately 0.7-12% of all lumbar disc herniations. Compared to the more common central and paramedian lumbar disc herniations, they cause more severe and persistent radicular pain due to direct compression of the nerve root and dorsal root ganglion. In patients who do not respond to conservative treatments such as medical treatment and physical therapy, and have not developed neurological deficits, it is difficult to decide on surgical treatment because of the nerve root damage and spinal instability risk due to disruption of facet joint integrity. In this study, we aimed to evaluate the effect of transforaminal epidural steroid injection (TFESI) on the improvement of both pain control and functional capacity in patients with FLDH. A total of 37 patients who had radicular pain caused by far lateral disc herniation which is visible in their lumbar magnetic resonance imaging (MRI) scan, had no neurological deficit and did not respond to conservative treatment, were included the study. TFESI was applied to patients by preganglionic approach. Pre-treatment Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) scores of the patients were compared with the 3rd week, 3rd month and 6th month scores after the procedure. The mean initial VAS score was 8.63 ± 0.55, while it was 3.84 ± 1.66, 5.09 ± 0.85, 4.56 ± 1.66 at the 3rd week, 3rd month and 6th month controls, respectively. This decrease in the VAS score was found statistically significant (p = 0.001). ODI score with baseline mean value of 52.38 ± 6.84 was found to be 18.56 ± 4.95 at the 3rd week, 37.41 ± 14.1 at the 3rd month and 34.88 ± 14.33 at the 6th month. This downtrend of pa­tient’s ODI scores was found statistically significant (p = 0.001). This study has demonstrated that TFESI is an effective method for gaining increased functional capacity and pain control in the treatment of patients who are not suitable for surgical treatment with radicular complaints due to far lateral lumbar disc hernia.

Clinical Neuroscience

Comparison of direct costs of percutaneous full-endoscopic interlaminar lumbar discectomy and microdiscectomy: Results from Turkey

ÜNSAL Ünlü Ülkün, ŞENTÜRK Salim

Microdiscectomy (MD) is a stan­dard technique for the surgical treatment of lumbar disc herniation (LDH). Uniportal percutaneous full-endoscopic in­terlaminar lumbar discectomy (PELD) is another surgical op­tion that has become popular owing to reports of shorter hos­pitalization and earlier functional recovery. There are very few articles analyzing the total costs of these two techniques. The purpose of this study was to compare total hospital costs among microdiscectomy (MD) and uniportal percutaneous full-endoscopic interlaminar lumbar discectomy (PELD). Forty patients aged between 22-70 years who underwent PELD or MD with different anesthesia techniques were divided into four groups: (i) PELD-local anesthesia (PELD-Local) (n=10), (ii) PELD-general anesthesia (PELD-General) (n=10), (iii) MD-spinal anesthesia (MD-Spinal) (n=10), (iv) MD-general anesthesia (MD-General) (n=10). Health care costs were defined as the sum of direct costs. Data were then analyzed based on anesthetic modality to produce a direct cost evaluation. Direct costs were compared statistically between MD and PELD groups. The sum of total costs was $1,249.50 in the PELD-Local group, $1,741.50 in the PELD-General group, $2,015.60 in the MD-Spinal group, and $2,348.70 in the MD-General group. The sum of total costs was higher in the MD-Spinal and MD-General groups than in the PELD-Local and PELD-General groups. The costs of surgical operation, surgical equipment, anesthesia (anesthetist’s costs), hospital stay, anesthetic drugs and materials, laboratory wor­kup, nur­sing care, and postoperative me­dication diffe­red significantly among the two main groups (PELD-MD) (p<0.01). This study demonstrated that PELD is less costly than MD.

Lege Artis Medicinae

[Diagnosis and treatment of microvascular coronary heart disease. Specialities of conditions in Hungary]

SZAUDER Ipoly

[Invasive investigations show that in two-thirds of patients the myocardial ischaemia persists without obstructive coronary disease and any other heart conditions (INOCA). The underlying cause may be microvascular dysfunction (CMD) with consecutive microvascular coronary disease (MVD) and microvascular or epicardial vasospastic angina (MVA). The modern practice of clinical cardiology while using the developed non-invasive cardiac imaging permits exact measuring of the coronary flow with its characteristic indices. All of these improve the diagnosing of CMD-induced myocardial ischemia and provide opportunity to determine primary MVD cases. Since the recognition and treatment of MVD is significantly underrep­resented in the Hungarian medical care, the primary stable microvascular angina (MVA) is described in detail below with its modern invasive and non-invasive differential diagnosis and treatment, concerning especially its frequency provoked by high blood pressure and female coronary heart diseases. There are highlighted all recommended diagnostic procedures available under domestic conditions.]

Hypertension and nephrology

[About the care of patients with hyperuricaemia and gout]

[This consensus document is intended to provide guidance for the effective and efficient treatment of asymptomatic individuals with high uric acid levels and gout patients.]

Lege Artis Medicinae

[Focus on Lege Artis Medicinae (LAM)]

VASAS Lívia, GEGES József

[Three decades ago, LAM was launched with the goal of providing scientific information about medicine and its frontiers. From the very beginning, LAM has also concerned a special subject area while connecting medicine with the world of art. In the palette of medical articles, it remained a special feature to this day. The analysis of the history of LAM to date was performed using internationally accepted publication guidelines and scientific databases as a pledge of objectivity. We examined the practice of LAM if it meets the main criteria, the professional expectations of our days, when publishing contents of the traditional printed edition and its electronic version. We explored the visibility of articles in the largest bibliographic and scientific metric databases, and reviewed the LAM's place among the Hun­ga­rian professional journals. Our results show that in recent years LAM has gained international reputation des­pite publishing in Hungarian spoken by a few people. This is due to articles with foreign co-authors as well as references to LAM in articles written exclusively by foreign researchers. The journal is of course full readable in the Hungarian bibliographic databases, and its popularity is among the leading ones. The great virtue of the journal is the wide spectrum of the authors' affiliation, with which they cover almost completely the Hungarian health care institutional sys­tem. The special feature of its columns is enhanced by the publication of writings on art, which may increase Hungarian and foreign interest like that of medical articles.]