In patients with drug-resistant focal epilepsy requiring surgery, hippocampal sclerosis was the most common histopathological diagnosis among adults, and focal cortical dysplasia was the most common diagnosis among children. Tumors were the second most common lesion in both groups. (Funded by the European Union and others.).

Recent studies indicate that aerobic activities might reduce severity and/or frequency of migraine attacks. The present study was intended to investigate whether physical activities and fitness (aerobic endurance, flexibility, and muscle strength endurance) as well as body composition are different in patients with headache disorders and healthy control subjects. The study included 56 patients (aged 17-64 years) with headache disorders (migraine, tension-type, cluster, analgetics abuse, and other types of headache) and 145 age-matched volunteers without history of recurrent or chronic headache. A standardized questionnaire revealed similar self-esteem of physical activities in both groups. Objective physical fitness testing in a representative sample of 22 patients and 36 control subjects showed significantly reduced aerobic endurance in female and male patients as well as reduced flexibility in female patients as compared to control subjects, whereas muscle strength endurance was not significantly different between both groups. Female patients presented with a significantly higher total body fat as compared to control subjects. In conclusion, headache patients turned out to be less physically fit than control subjects. There was a discrepancy between self-esteem and objective test results regarding physical activity and fitness in patients with headache disorders.

No abstract

Felbamate is a new anticonvulsant which has already been marketed in some countries outside Germany, i. e., in the United States. Since marketing in Germany is in progress, one may soon expect felbamate to be in clinical use. Both the chemical structure and the probable mechanism of action are different from the currently available antiepileptic drugs. The studies already published allow to expect felbamate to improve substantially the possibilities of antiepileptic pharmacotherapy, since it is an anticonvulsant with a high efficacy in the treatment of partial epilepsy and especially with a very good tolerability. Its disadvantage are numerous interactions with other antiepileptic drugs. This article is an update review of the literature on felbamate.

Topiramate is a new antiepileptic drug, which is not yet marketed in Germany. The anticonvulsive activity is probably mediated by sodium-channel blockade combined with gabaergic and weak antiglutamatergic properties. We investigated 23 patients with partial seizures in this open prospective study. The efficacy was analysed under stable concurrent antiepileptic drugs. Two of the patients became seizure free. Ten patients had a reduction of seizure frequency of at least 50%. The responder rate was 57%. The maximum daily dosages were 400 to 850 mg. Side-effects without relationship to dose were nervousness and aggression. In two patients an psychotic episode occurred. Dose-related side-effects were ataxia, dizziness, somnolence and dysarthria. This study is underlining that topiramate is efficacious in the treatment of partial onset seizures but also associated with a narrow therapeutic width.