Rolandic paroxysmal epilepsy: a long term study in 150 children

150 children with Rolandic paroxysmal epilepsy (RPE) aged 3 to 12 years were followed up clinically and by EEG for 16 years. Antiepileptic drugs were administered initially for 2 years and then suspended for 6–12 months. Treatment was resumed in the 29 patients who had seizures during the drug-free interval and was maintained for a further 5 years.80.6% of all patients were in clinical remission after the 2-year treatment period. Some patients had seizures while on drugs, others during the drug-free interval. Seizure frequency declined with age. No seizures occured after the age of 14 or in the 8 years following final discontinuation of drug therapy. The need for prolonged drug treatment is therefore questioned.

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Sommario 150 bambini affetti da Epilessia a Parossismi Rolandici, di età compresa tra i 3 e i 12 anni, sono stati tenuti sotto controllo clinico ed elettroencefalografico per un periodo di sedici anni.È stato effettuato un trattamento con farmaci antiepilettici per 2 anni. Dopo 6/12 mesi di wash-out farmacologico, in 29 pazienti che hanno manifestato crisi, la terapia farmacologica è stata ripristinata e mantenuta per 5 anni.Dopo i primi due anni di terapia, si è avuta una remissione clinica nell'80.6% dei casi. Alcuni pazienti hanno manifestato crisi durante l'assunzione della terapia, altri durante il periodo di wash-out. In ogni caso l'incidenza delle crisi diminuisce con il crescere dell'età dei pazienti. Al di sopra dei 14 anni non sono state registrate crisi, e l'osservazione durante gli otto anni successivi alla sospensione definitiva della terapia farmacologica non ha rivelato la comparsa di alcuna crisi.Viene quindi discussa la necessità di un trattamento farmacologico prolungato in corso di Epilessia a Parossismi Rolandici.

     

2020 developments in the provision of early medical abortion by telemedicine in the UK

The COVID-19 pandemic has necessitated the rapid implementation of telemedical health services. In the United Kingdom, one service that has benefitted from this response is the provision of early medical abortion. England, Wales, and Scotland have all issued approval orders to this effect. These orders allow women to terminate pregnancies up to certain gestational limits, removing the need for them to contravene social distancing measures to access care. However, they are intended only as temporary measures for the duration of the pandemic response. In this paper, we chart these developments and further demonstrate the already acknowledged politicisation of abortion care. We focus on two key elements of the orders: (1) the addition of updated clinical guidance in the Scottish order that suggests an extended gestational limit, and (2) sunset clauses in the English and Welsh orders, as well as an indication of similar intentions in Scotland. In discussing these two issues, we suggest that the refusal of UK governments to introduce telemedical provision of early medical abortion previously has not been based on health concerns. Further, we question whether it would be appropriate for the approval orders to be lifted following the pandemic, suggesting that to do so would represent regressive and harmful policy.     

Spasmophilia: a clinical neurophysiopathological and biochemical study

Spasmophilia is a problem much debated as regards its nosographic location. Its paroxysmal onset in a "neurotic" patient has confined spasmophilia within a psychiatric syndromic complex for many years. In the present study, strict clinical criteria used in selecting a population of spasmophilic patients included clinical, neurophysiological, biohumoral and psychological evaluations, providing further information about the real organic features of this syndrome. Moreover, on the basis of an organic pathogenetic hypothesis, all patients were administered medical therapy which resulted in clinical amelioration in a significant number of cases.     

The Case for Telemedical Early Medical Abortion in England: Dispelling Adult Safeguarding Concerns

Health Care Analysis - Access to abortion care has been hugely affected by the COVID-19 pandemic. This has prompted several governments to permit the use of telemedicine for fully remote care...     

Basilar migraine with electroencephalographic findings of occipital spike-wave complexes: a long-term study in seven children

Basilar migraine is characterized by headache preceded by prodromal symptoms and signs of posterior cerebral circulation dysfunction. Few studies have focused on EEG findings in this condition or on the prognosis of occipital spike-wave complexes observed in either migraine or epilepsy. We now report a long-term follow-up (8–16 years) in seven children affected by basilar migraine who had EEG findings of occipital spike-wave complexes. Basilar migraine resolved and the EEG became normal in all subjects during the observation period, as did migraine with aura and seizures which developed in some of the patients after basilar migraine attacks ceased.     

Migraine and other clinical syndromes in children affected by EEG occipital spike-wave complexes

Twenty EEG recordings obtained in children showed temporo-parieto occipital or temporo-occipital spikes or spike-wave complexes suppressed by eye-opening. Patients showed different neurological syndromes: classic migraine, vertebrobasilar migraine, visual phenomena, epilepsy, psychomotor retardation. Thirteen subjects were affected by epileptic seizures, which were preceded by visual phenomena in 12 cases. In 6 cases, a combination of classic migraine, visual phenomena and seizures was found. In one case of vertebrobasilar migraine, seizures occurred 5 years after the first episode of migraine. Follow-up data indicate a non-benign evolution of occipital epilepsy: partial or generalized seizures persisted in 13 treated cases. Moreover, the EEG finding of occipital spike-wave complexes seems to extend to different neurological syndromes.     

Migraine and Epilepsy With Infantile Onset and Electroencephalographic Findings of Occipital Spike-wave Complexes

An EEG finding of temporo-occipital or temporo-parieto-occipital spike-wave complexes, suppressed by eye opening, coexisting with classical migraine, was observed in 14 children; in 13 of these patients, seizures were present. Classical migraine, visual phenomena and seizures coexisted in different clinical patterns.