We carried out a Hungarian multicentre study to assess the frequency of the occurrence of warning symptoms preceding epileptic seizure. The data of 562 patients with epilepsy out of a total of 1124 were analysed on the basis of questionnaires filled in under standard conditions. About 50% of the patients experienced warning symptoms before a smaller or greater part of their seizures. Their appearance was fairly consistent and became mainly manifested in the form of headache, epigastric sensation and dysphoria. In relation to epileptological basic data, it was found that warning symptoms appeared primarily in focal epilepsies and among them they mainly preceded generalized tonic clonic and complex partial seizures. Between the warning symptom and the onset of the seizure there was usually a longer interval during which (and generally also during the warning symptom) the patient remained able to act. About 20% of the patients enrolled in the study tried to inhibit the onset or mitigate the course of the seizure and about 10% judged their spontaneous activity carried out in that direction to be successful. The frequency of the occurrence of independent prognostic symptoms not followed by a seizure was relatively low, and among epileptics with warning symptoms the incidence of seizures occurring without a preceding event was not high either. Based on our experiences, we have drawn the conclusion that, in a significant part of epileptic patients, the warning symptoms render possible the supplementation of the therapy by the development of seizure-inhibiting or seizure-avoiding behaviour or activity.

Correlations between occurrence of complex partial seizures and altered sleep duration were analyzed in a small but strongly homogeneous population of temporal lobe epilepsy patients. Sleep deprivation and oversleep were determined individually; 682 epileptic seizures occurring on 4,995 days were related to occasional alterations of night sleep duration. The seizure-inducing effect of an actual relative sleep deprivation was 67-100% in four cases and 49-64% in four cases. Oversleep had no consistent seizure-provoking effect. Relative sleep deprivation may have a seizure-provoking effect, especially in temporal lobe epilepsy. This information may be used to instruct epileptic patients concerning sleep hygiene which might improve the efficacy of antiepileptic drug (AED) treatment, even if no change is made in medication.

1 Antidepressant drugs produce significant changes in human brain function as reflected in the quantitatively analysed EEG. Two main types of pharmaco-EEG profiles may be differentiated: a thymeretic (desipramine-like) profile characterised mainly by an alpha increase suggesting activating properties and a thymoleptic (imipramine-or amitriptyline-like) profile showing a concomitant increase of slow and fast activities and a decrease in alpha activity indicating also sedative qualities. A small number of compounds exhibit still different profiles. 2 Aside from determining the type of EEG changes, the pharmaco-EEG method seems to be of value in determining time and dose efficacy relations at the target organ, the human brain. Moreover, the relationships between pharmacodynamics and pharmacokinetics may be determined. 3 Fluvoxamine, a selective 5-hydroxytryptamine (5-HT) re-uptake inhibitor from the new class of 2-aminoethyloximethers of aralkylketones, produced a typical thymoleptic pharmaco-EEG profile after oral doses of 75 mg in a double-blind placebo-controlled study involving 10 healthy volunteers. Fluvoxamine (75 mg) induced less augmentation of slow activity than 75 mg imipramine, indicating less sedative properties of fluvoxamine than imipramine. 4 After 75 mg fluvoxamine psychometric tests demonstrated a tendency towards an improvement in attention, concentration, psychomotor activity, after-effect and mood and a significant increase in critic,I flicker fusion frequency as compared with placebo. Comparison with the reference drug, 75 mg imilrfmine, revealed a significant superiority of fluvoxamine regarding concentration, psychomotor act. 4y, tapping, reaction time, mood and affectivity.5 Side-effects (mostly tiredness) were seen in five out of 10 subjects after 75 mg fluvoxamine and in eight out of 10 subjects after 75 mg imipramine. There were no clinically relevant changes in pulse, systolic and diastolic blood pressure.

The present study concludes that the PSQI-HUN is a reliable, valid, and standardized measure for assessment of the subjective sleep quality in clinical and research settings.

Simple acoustic stimuli were delivered at the onset of absence seizures in 23 investigations of 19 patients. In 79 of 139 observations, the stimulation promptly inhibited the seizure. The most effective inhibition was achieved in the first 3 s of the absence seizure. An automatic system of self-stimulation is recommended for further investigations. Following solution of some theoretical questions and technical problems, the suggested method can become a new therapeutic modality in seizure treatment.