Browsing by Author "Lević, Z. (7003341242)"

The cerebrospinal fluid (CSF) and plasma pharmacokinetics of phenobarbital were studied after intravenous administration to 5 epileptic patients with convulsive status epilepticus and 6 seizure-free patients with newly diagnosed epilepsy. Phenobarbital (15 mg/kg) was infused at a rate of 100 mg/min. Plasma was collected prior to and throughout 24 hours after drug administration. The CSF samples were obtained by lumbar puncture 2 hours after the institution of phenobarbital infusion. Phenobarbital concentrations in plasma and the CSF were measured by reverse-phase liquid chromatography. The plasma values of pharmacokinetic variables of distribution and elimination did not differ between the groups. Slightly lower phenobarbital concentrations in the group of patients experiencing status epilepticus compared with seizure-free epileptic patients during the first hours after drug administration and the resultant elevated value of the rate constant distribution (α) did not reach statistical significance, probably due to the small number of participants in the study. Phenobarbital concentrations were approximately 40% higher in the CSF of epileptic patients with status epilepticus compared with nonconvulsing subjects. The rate constant of phenobarbital distribution in the CSF (the ratio of the CSF concentration of the drug at time t1 and the area under the plasma concentration-time curve up to t(l)) in epileptic patients with status epilepticus exceeded that in seizure-free patients (0.29 ± 0.06 h-1 vs 0.19 ± 0.05 h-1, p < 0.05). The study demonstrated statistically significantly higher phenobarbital concentrations and more rapid appearance of phenobarbital in the CSF of epileptic patients with status epilepticus compared with nonconvulsing patients with epilepsy. The alteration in the pharmacokinetics of phenobarbitone in patients experiencing status epilepticus reported here additionally supports the reported efficacy of intravenous phenobarbital in the treatment neurological disorder.

The authors report the results of a 2 yr study of 70 cases of craniocerebral injuries selected with a view to attempting a clinical identification of the posttraumatic cerebral psychosyndrome and its differentiation from neurotic reactions. They give a detailed individual and correlative analysis of data on the kind and severity of injuries, subjective complaints, objective neuropsychiatric examination, psychograms, EEG, and otologic findings. They extract cases of the psychoneurological posttraumatic syndrome characterized by a 'disautomation of psychic processes' and reduced mental efficacy. A clinico psychological analysis and 40 tested cases have shown that regularly encountered emotional disorders are primary traumas rather than a secondary reaction to intellectual difficulties. Although associations between the psychosyndrome and neurological reactions are very complicated, it does appear clear that isolated focal signs have no significant correlation with the psychosyndrome. This correlation, however, is often expressed by the signs connected in clinical neurology with frontal lobes and the bilateral lesions of the motor system.

[No abstract available]

[No abstract available]

The aim of our study was to analyse clinical and paraclinical characteristics of patients with multiple sclerosis (MS) with previous diagnosis of primary-progressive (PP) MS according to the Poser's criteria and further investigate if they fulfil the McDonald's diagnostic criteria for this disorder. A total of 561 MS patients were registered in the database at the Institute of Neurology, Belgrade, from 1 January 1997 to 31 December 2000 and 63 of them (11.2%) with previous diagnosis of PPMS were analysed retrospectively. Male/female ratio was 1.3:1 and mean age at onset 33.2 years. Most frequent at onset were pyramidal (in 73% of patients) and sensory symptoms (in 41% of patients); 74.6% of patients had greater than or equal to nine brain magnetic resonance imaging (MRI) lesions. Intrathecal oligoclonal immunoglobulin G (IgG) was detected in 96.7% and prolonged visual evoked potentials (VEP) P100 latency in 82.4% of patients. Of the total study group of 561 patients, 10.2% fulfilled the recently recommended McDonald's diagnostic criteria for the diagnosis of PPMS. Our findings further support the significance of the brain/spinal cord MRI, cerebrospinal fluid and VEP findings for precise diagnostic assessment in patients with suspected PP form of MS.

The aim of our study was to analyse clinical and paraclinical characteristics of patients with multiple sclerosis (MS) with previous diagnosis of primary-progressive (PP) MS according to the Poser's criteria and further investigate if they fulfil the McDonald's diagnostic criteria for this disorder. A total of 561 MS patients were registered in the database at the Institute of Neurology, Belgrade, from 1 January 1997 to 31 December 2000 and 63 of them (11.2%) with previous diagnosis of PPMS were analysed retrospectively. Male/female ratio was 1.3:1 and mean age at onset 33.2 years. Most frequent at onset were pyramidal (in 73% of patients) and sensory symptoms (in 41% of patients); 74.6% of patients had greater than or equal to nine brain magnetic resonance imaging (MRI) lesions. Intrathecal oligoclonal immunoglobulin G (IgG) was detected in 96.7% and prolonged visual evoked potentials (VEP) P100 latency in 82.4% of patients. Of the total study group of 561 patients, 10.2% fulfilled the recently recommended McDonald's diagnostic criteria for the diagnosis of PPMS. Our findings further support the significance of the brain/spinal cord MRI, cerebrospinal fluid and VEP findings for precise diagnostic assessment in patients with suspected PP form of MS.