4 research outputs found
Giant Aneurysm of Basilar Artery
In the article we showed the patient, a woman with unruptured giant aneurysm of basilar artery, we showed the done
examinations, and therapy dilemmas about what to do in the given case. We found in literature a number of examples
which suggest operation treatment, but of embolisation too, some suggest conservative treatment
Head Trauma and Posttraumatic Epilepsy in Slavonski Brod, East Croatia, 1988-2008
Posttraumatic epilepsy is result of head trauma. The aim of our research was to establish how many patients after head trauma developed posttraumatic epilepsy (PTE). Retrospectively we analyzed 50 patients with head trauma different severity in period from 1989. to 2008., which we werified radiological, electroenfephalographic, and psychical changes were established according pto psychiatric examination. From 50 patient with head trauma, 40 developed seizures (3 in the firs 24 hours and 6 after first 24 hours to the end of first week, 31 after first week). By introducing antiepileptic therapy (AETh), 30 patients were seizure free, 10 patients had 1-2 epileptic seizure monthly (EPA/CPA), 10 patients got prophylactic AETh in period 6-12 months. 14 patients developed psychical changes which were verified by psychiatrist. The experience and literature show that posttraumatic epilepsy is good for treating with 1 or 2 antiepileptic, and remission is more difficult in case psychiatric comorbidity
Head Trauma and Posttraumatic Epilepsy in Slavonski Brod, East Croatia, 1988-2008
Posttraumatic epilepsy is result of head trauma. The aim of our research was to establish how many patients after head trauma developed posttraumatic epilepsy (PTE). Retrospectively we analyzed 50 patients with head trauma different severity in period from 1989. to 2008., which we werified radiological, electroenfephalographic, and psychical changes were established according pto psychiatric examination. From 50 patient with head trauma, 40 developed seizures (3 in the firs 24 hours and 6 after first 24 hours to the end of first week, 31 after first week). By introducing antiepileptic therapy (AETh), 30 patients were seizure free, 10 patients had 1-2 epileptic seizure monthly (EPA/CPA), 10 patients got prophylactic AETh in period 6-12 months. 14 patients developed psychical changes which were verified by psychiatrist. The experience and literature show that posttraumatic epilepsy is good for treating with 1 or 2 antiepileptic, and remission is more difficult in case psychiatric comorbidity
Smjernice za farmakoloÅ”ko lijeÄenje epilepsije
SAŽETAK
MeÄunarodne smjernice za farmakoloÅ”ko lijeÄenje epilepsija opÄenite su, sveobuhvatne i ne prepoznaju lokalne specifiÄnosti poput ekonomskih i tehniÄkih moguÄnosti u pojedinim državama, dostupnosti pojedinih antiepileptika ili drugih metoda lijeÄenja i sliÄno. Stoga se nameÄe potreba izrade nacionalnih smjernica, Äiji su zapravo temelj meÄunarodne smjernice Internacionalne lige protiv epilepsije. Hrvatske smjernice za farmakoloÅ”ko lijeÄenje epilepsija plod su suradnje svih relevantnih struÄnih druÅ”tava i referentnih centara u RH, na Äelu s Hrvatskom ligom protiv epilepsije te Hrvatskim neuroloÅ”kim druÅ”tvom i Hrvatskim druÅ”tvom za djeÄju neurologiju Hrvatskoga lijeÄniÄkog zbora, a odražavaju aktualne socioekonomske i regulatorne specifiÄnosti u naÅ”oj zemlji, najnovije spoznaje farmakoloÅ”kih profila i uÄinkovitosti pojedinih antiepileptika kao i ekspertna miÅ”ljenja. AntiepileptiÄka terapija se uvodi nakon postavljanja dijagnoze epilepsije, stoga profilaktiÄka primjena nije opravdana. Nakon postavljanja dijagnoze potrebno je bolesnika informirati o prognozi bolesti, moguÄnostima lijeÄenja i samopomoÄi, životnim ograniÄenjima te moguÄim neželjenim dogaÄajima. Ciljevi farmakoterapije epilepsija su potpuna kontrola napada uz izbjegavanje nuspojava te održavanje ili poboljÅ”anje kvalitete života. Zlatni standard lijeÄenja je monoterapija odnosno primjena adekvatnog antiepileptika u adekvatnoj dozi. Izbor i titracija lijeka su individualni, a temelje se na smjernicama za lijeÄenje pojedinih vrsta napada, karakteristikama bolesnika i regulatorno specifiÄnim Äimbenicima. Nakon neuspjeha inicijalne monoterapije, potrebna je reevalucija anamnestiÄkih i dijagnostiÄkih podataka te potom postupna i spora zamjena antiepileptika. Racionalna politerapija podrazumijeva kombinaciju dvaju antiepileptika razliÄitih mehanizama djelovanja, prvog ili eventualno drugog izbora za postavljenju dijagnozu, niskoga interakcijskog potencijala, razliÄitog profila nuspojava i sinergistiÄkog ili aditivnog djelovanja. Zamjena generiÄkih ili originalnog i generiÄkog oblika lijeka nije preporuÄljiva, a poglavito nakon postizanja remisije ili prilikom uzimanja visokih doza lijeka. Ukidanje antiepileptiÄke terapije treba biti postupno i sporo, u sluÄaju politerapije jedan po jedan lijek, a u donoÅ”enju odluke o ukidanju, kao i o uvoÄenju antiepileptika, mora biti ukljuÄen bolesnik i njegova obitelj