No abstract

Of 1300 epileptic patients 76 (5.8%) were found to have juvenile myoclonic epilepsy (JME). These 76 patients were examined at the epilepsy outpatient clinic of Bakirköy State Hospital for Neurological and Psychiatric Diseases between 1991 and 1996 and data obtained were analysed retrospectively. Clinically typical absence seizures were reported in 40.8%, myoclonic jerks in 100%, and generalized tonic-clonic seizures in 82.9% of the patients. Neurological and mental examination was normal for all patients with the exception of three cases; two with essential tremor and one with minimal dysarthria. Precipitating factors were noted in 85.5% of cases. Abnormal EEG was recorded in 73 (6.1%) patients. Abnormalities mainly consisted of generalized discharges of spike/polyspike and slow-wave (86.6%) and generalized paroxysmal theta or delta (9.2%). Fifteen (19.7%) had focal abnormalities and 20 (26.4%) had photoconvulsive discharges. Of the 76 patients, 40 (52.6%) were not diagnosed at the initial interview; definite diagnosis was delayed by a mean of 5.9 years. As a result of misdiagnosis at the initial interview 40 patients had been administered AED except for valproate. After reassessment of clinical and EEG findings, the medication was changed to valproate therapy. As a result, 65 of our JME patients (85.5%) were seizure free after a one-year follow-up period.

Epilepsy is a disease frequently seen among school children. Children having seizures may bother their teachers, who do not receive specific training about epilepsy during their education. Moreover, teachers feel desperate not knowing how to handle the situation. In a series of seminars it was our aim both to investigate and to improve the present awareness, knowledge, and attitude of elementary school teachers about epilepsy in Istanbul. In the pre- and post-seminar tests teachers who attended the seminar on a voluntary basis, were asked 29 questions. There were 346 male and female participants aged (mean +/- S.D.) 32.19 +/- 7.25. 69.3% of the participating teachers had either read or heard about epilepsy, while 71.9% had seen someone having a seizure and 59.4% knew someone with epilepsy. Although they had some prior misconceptions, like considering epilepsy a contagious (2.3%) or a psychological disease (17.8%), the teachers' knowledge and awareness improved after the seminar due to their special interest in the subject. Consequently, their negative attitude toward the participation of people with epilepsy in sports and social activities diminished post seminar. However, it should be noted that further education not only of teachers but also of family members is always required.

Demographic, clinical and electrophysiological findings of our GBS cases were highly similar to those of the previous reports. Two of our cases were presented with preceding tuberculosis infection, which was not reported before in the literature.

Recent studies have demonstrated that central neuronal hyperexcitability has an important role in migraine pathogenesis. Hyperexcitability of occipital cortex has been proposed to be responsible for the elaboration of migraine attacks and visual aura. Motor symptoms in some migraine subtypes have also drawn attention to the hyperexcitability of motor cortex. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] Transcranial magnetic stimulation (TMS) is a non-invasive tool to investigate physiology and excitability of both motor-and occipital cortices. 11,[21][22][23][24][25] The changes in motor threshold, latency and amplitude of motor evoked potential, central motor conduction time and cortical silent period after magnetic ABSTRACT: Objective: We evaluated motor and occipital cortex excitability in migraine patients using transcranial magnetic stimulation. Methods: In this study, we included 15 migraine patients with aura (MwA), 15 patients without aura (MwoA) between attacks, and 31 normal healthy controls. Motor thresholds at rest, amplitudes of motor evoked potentials, central motor conduction time and cortical silent period were measured by stimulation of the motor cortex by using 13.5 cm circular coil and recording from abductor digiti minimi muscle. Additionally, phosphene production and the threshold of phosphene production was determined by stimulation of the visual cortex with the same coil. Results: No significant differences were observed between the groups with respect to the motor thresholds, Motor evoked potential max/compound muscle action potential max (MEPmax/Mmax) amplitudes, central motor conduction times and duration of cortical silent period. Although not statistically significant, the proportion of the migraineurs with phosphene generation (90%) was found to be higher than that of normal controls (71%). Phosphene threshold levels in migraine patients, however, were significantly lower than those of the controls with MwA patients having the lowest levels. Conclusion: Our findings indicate that the occipital cortex, but not the motor cortex, is hyperexcitable in migraine patients. RÉSUMÉ: Excitabilité du cortex moteur et du cortex occipital chez les patients migraineux.Objectif: Nous avons évalué par stimulation magnétique transcrânienne l'excitabilité du cortex moteur et du cortex occipital chez des patients migraineux. Méthodes: Nous avons étudié entre les crises 15 patients ayant une migraine avec aura (MaA), 15 patients migraineux sans aura (MsA) et 31 témoins en bonne santé. Les seuils moteurs au repos, les amplitudes des potentiels évoqués moteurs (PÉM), le temps de conduction moteur central et la période de silence cortical ont été mesurés par stimulation du cortex moteur au moyen d'une spirale circulaire de 13,5 cm et enregistrement au niveau du muscle abducteur du petit doigt. De plus, la production de phosphènes et le seuil de production de phosphènes ont été déterminés par stimulation du cortex visuel avec la même spirale. Résultats: Nous n'avons observé aucune...