Authors' contribution Wkład autorów: A. Study design/planning zaplanowanie badań B. Data collection/entry zebranie danych C. Data analysis/statistics dane-analiza i statystyki D. Data interpretation interpretacja danych E. Preparation of manuscript przygotowanie artykułu F. literature analysis/search wyszukiwanie i analiza literatury G. Funds collection zebranie funduszy Summary Background. It is estimated that approximately 1% of people worldwide suffer from epilepsy. Currently available antiepileptic drugs (AEDs) are able to control epileptic seizures in about 70% of cases. In the remaining patients (30%), the application of two or three AEDs in combination is necessary for effective seizure management. The goal of this work was to characterize the interaction of three AEDs: lacosamide (lCM), carbamazepine (CBZ) and valproate (VPA) at the fixed-ratio of 1:1:1 in the mouse tonic-clonic seizure model. Material and methods. Male albino Swiss mice, after receiving a combination of lCM, CBZ and VPA, were challenged with electric current to evoke tonic hind limb extension (seizure activity). Protection of the mice from tonic-clonic seizures was assessed by isobolographic analysis to determine the type of interaction occurring between these drugs. Results. Type I isobolographic analysis revealed that the combination of lCM, CBZ and VPA produced infra-additive (antagonistic) interaction in the mouse tonic-clonic seizure model. Conclusions. Since the three-drug mixture of lCM, CBZ and VPA exerted an antagonistic interaction in the tonic-clonic seizure test in mice, we would caution physicians against treating epilepsy patients with this unfavorable combination.

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Introduction. Assessment of interactions among antiepileptic drugs (AEDs) during polytherapy is still a challenging issue for physicians and epileptologists worldwide. In spite of 25 currently licensed AEDs, there are no algorithms allowing a proper choice of these drugs to create combinations which would offer epileptic patients an efficacious therapy in the case of seizures refractory to monotherapeutic use of the AEDs. To characterize a type of interaction for a three-drug mixture of oxcarbazepine (OXC), pregabalin (PGB) and topiramate (TPM) in an experimental model of tonic-clonic seizures, an isobolographic analysis of interaction was applied. Materials and Method. The anticonvulsant effects of the three-drug mixture of OXC, PGB and TPM with respect to suppression of tonic-clonic seizures in mice were assessed in the mouse maximal electroshock-induced seizure model. Type I isobolographic analysis was used to characterize the type of interactions among three AEDs. Potential acute adverse effects were evaluated in the chimney, passive avoidance and grip-strength tests. Results. The three-drug mixture of OXC, PGB and TPM exerted supra-additive (synergistic) interaction in the mouse maximal electroshock-induced seizure model. The combination of OXC, PGB and TPM did not produce any acute adverse effects in mice in the chimney, passive avoidance and grip-strength tests. Conclusions. The isobolographic synergy observed experimentally for the combination of OXC, PGB and TPM could be recommended to patients with drug-resistant epilepsy, if the results of this study were translated to clinical settings.

Purpose: Limbic encephalitis (LE) is a rare but necessary condition to consider when experiencing cognitive disorders, seizures, and psychiatric disorders. Case description: This article presents a case of a 28-year-old patient with uncontrolled disease history, with systemic symptoms of viral infection and prolonged convulsive seizure status. Based on clinical symptoms, magnetic resonance imaging of the brain and cerebrospinal fluid test results revealed LE. After treatment and rehabilitation, the patient returned to work. Comment: Limbic encephalitis was first described in 1960. In terms of aetiology, we divide LE into non-infectious (a para nitrogen syndrome primarily associated with small cell lung cancer) and infectious cases (caused by herpes simplex virus). Other cases of autoimmune diseases have also been reported -non-paraneoplastic limbic encephalitis (NPLE), in which the presence of antibodies against the antigen of the neuronal membrane is observed. Non-paraneoplastic LE variants are examples of potentially reversible LE variants. Key words: limbic encephalitis, paraneoplastic syndrome, onconeuronal antibodies. StreszczenieCel: Limbiczne zapalenie mózgu (LE) jest chorobą rzadką, którą należy jednak uwzględnić w przypadku wystąpienia u pacjenta zaburzeń poznawczych, napadów padaczkowych i zaburzeń psychicznych. Opis przypadku: W pracy przedstawiono przypadek 28-letniej pacjentki z nieobciążonym wywiadem chorobowym, u której wystąpiły objawy ogólnoustrojowe infekcji wirusowej oraz przedłużający się drgawkowy stan padaczkowy. Na podstawie objawów klinicznych, obrazu rezonansu magnetycznego mózgu i wyników badań płynu mózgowo-rdzeniowego rozpoznano LE. Po leczeniu i rehabilitacji pacjentka wróciła do poprzednio wykonywanej pracy. Komentarz: Limbiczne zapalenie mózgu zostało opisane po raz pierwszy w 1960 r. Pod względem etiologicznym wyróżniamy przypadki nieinfekcyjne LE (o charakterze zespołu paranowotworowego związanego głównie z rakiem drobnokomórkowym płuc) oraz przypadki infekcyjne LE (spowodowane przez wirusa opryszczki pospolitej). Opisano również przypadki związane z chorobami