Seventy-eight patients with temporal lobe type seizures were precisely matched for age, sex, and Wechsler I.Q. levels with patients suffering from other seizure types. Statistically significant differences were established between the groups in regard to treatment response, etiologies, and behavioral variables. Further analysis of the data showed that the behavioral problems of the temporal lobe patients were present only in that group that suffered from more than one seizure type. That temporal lobe epilepsy group having only one seizure type differed from the controls with one seizure type in regard to etiological factors; they actually showed better performance on certain subscales of the WAIS, as well as better employment records. The clinical impression of the temporal lobe epilepsy patient usually presenting more difficulties than other patients with epilepsy results from the fact that the temporal lobe patients have, in the overwhelming majority of instances, more than one seizure type.
Summary A double‐blind study of the anticonvulsant and psychotropic properties of carbamazepine (Tegretol®) was undertaken in 37 hospitalized patients with intractable psychomotor epilepsy. Patients were first stabilized on diphenylhydantoin and phenobarbital, 10 to 15/xg/ml in serum, and then received for two 3‐week periods identical capsules containing either carbamazepine first, then placebo, or vice versa. Telemetric EEGs were recorded during each period and routine EEGs weekly; routine laboratory tests were also performed. Carbamazepine reduced the frequency of psychomotor seizures by 83%, and of grand mal seizures by 55%. It was ineffective in only 1 patient. Side effects were minor except in one patient who developed transient leukopenia. Behavioral effects were not demonstrable on a double‐blind basis. The drug tended to produce slowing of background EEG rhythms and sometimes diffuse paroxysmal activity; temporal spikes could diminish and be replaced by slow waves, or they could increase. Clinical seizures during telemetry were not preceded by any change in the record and were therefore unpredictable. Thus, carbamazepine is effective for treatment of psychomotor epilepsy and is safe when blood and platelet counts are checked. RÉsumé Chez 37 patients hospitalisés avec une épilepsie psychomotrice rebelle on a fait une étude en double aveugle sur les propriétés antiépileptiques et psychotropiques de la carbamazépine (Tégrétol).Les patients étaient d'abord mis à un traitement fixe de diphenylhydantoïne et de phénobarbital correspondant à 10–15 Aμg/ml dans le sérum et ensuite recevaient pendant deux périodes de 3 semaines des capsules identiques contenant de la carbamazepine ou un placebo. On effectuait pendant chaque période: des enregistrement EEG en télémetrie, un tracé EEG de routine chaque semaine, et des tests de routine de laboratoire. La carbamazépine a réduit de 83% la fréquence des crises psychomotrices et de 55% la fréquences des crises tonico‐cloniques généralisées. Le traitement a été sans effet chez un seul patient. Les effets secondaires ont été mineurs à l'exception d'un cas qui a présenté une leucopénie transitoire. Les effets sur le comportement n'etaient pas démontrables au cours d'étude en double aveugle. La carbamazépine avait tendance à ralentir l'activité de fond et parfois l'activité paroxystique diffuse; les pointes temporales pouvaient diminuer et faire place à des ondes lentes mais parfois elles pouvaient aussi augmenter. Les crises cliniques enregistrées pendant la télémétrie n'étaient pas précédées de modifications des tracés et étaient en conséquence imprévisibles. La carbamazépine est en conclusion un produit efficace dans le traitement de l'épilepsie psychomotrice et sans danger lorsque on fait des contrôles du sang et des plaquettes. RESUMEN Se ha realizado un estudio doble‐ciego de las propiedades anticonvulsivas y psicotrópicas de la carbamacepina (Tegretol) en 37 enfermos hospitalizados que padecian epilepsyia psicomotora resistente al tratamiento previo. Estos enfermos fuer...
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