Showing papers by "Drexel University published in 1980"

The palliation of brain metastases: Final results of the first two studies by the radiation therapy oncology group

Abstract: Five schedules of whole brain irradiation ranging from 4000 rad/4 weeks to 2000 rad/ 1 week have been evaluated in two sequential phase III randomized Radiation Therapy Oncology Group (RTOG I studies to determine palliative effectiveness in patients with metastatic brain disease. Improvement in neurologic function status and maintenance of improved or stable neurologic function were utilized as measures of response. All treatment schedules were comparable with respect to frequency of improvement, duration of improvement, time to progression, survival and palliative index. Important prognosticators of response included initial neurologic function and general performance status. Administration of steroids during irradiation favored more rapid improvement; for neurologic-function-3 patients, it increased the overall frequency of improvement. This result must be interpreted with caution since the administration of steroids was not controlled in either study. Patients whose disease is controlled at the primary site and in whom brain is the only site of metastases, constitute a prognostically favorable group; they may benefit from whole brain irradiation to higher doses. This population is currently under investigation in a third RTOG study.

Brain stem projections of sensory and motor components of the vagus complex in the cat: II. Laryngeal, tracheobronchial, pulmonary, cardiac, and gastrointestinal branches.

Abstract: The central sensory and motor connections of various respiratory, cardiovascular, and gastrointestinal viscera were analyzed using the transganglionic and retrograde transport of horseradish peroxidase (HRP). In 42 adult cats, we examined the brain stem and peripheral ganglia following microinjections of HRP (10 μl) into individual visceral organs—larynx, extrathoracic trachea, intrathoracic trachea, right main bronchus, right lung (upper lobe), heart, and stomach. Comparison of individual cases led to the conclusion that distinct patterns of sensory and motor projections to the medulla exist for each visceral organ studied. The nucleus of the tractus solitarius (nTS) receives the sensory projections from all the viscera listed above, with two exceptions: (1) a few sensory fibers from the larynx terminate in the ipsilateral spinal tract of the trigeminal nerve (spV), and (2) some sensory fibers from the bronchus, lung, and stomach terminate in the area postrema (ap). Within the nTS, the sensory fibers from each visceral organ terminate in a number of subnuclei. The dnTS, mnTS, and ncom receive sensory projections from all the viscera studied. The remaining five subnuclei (dlnTS, ni, nI, vlnTS, vnTS) of the nTS are not connected to all viscera, and the density of projections to these regions varies for different viscera. However, there does not seem to be any specific region of the medulla which is devoted entirely to receiving the sensory fibers from a particular visceral organ. Rather, the rostrocaudal extent of sensory fibers, from most of the viscera studied, spans the entire length of the medulla. Differences in the central representation of viscera were found to be subtle and to lie within the organization of the nuclear subgroups of the nTS. The central representation of unpaired or midline viscera (e.g., trachea and heart) is bilateral for both sensory and motor innervation. However, for unilateral, paired viscera (e.g., bronchi and lungs), it was consistently found that over one third of the sensory and motor representation is contralateral. Control experiments involving vascular injections of HRP excluded the possibility that this contralateral labeling could have been due to vascular uptake of the enzyme. The localization of sensory perikarya of visceral afferents in the “principal visceral ganglion” of the vagus—the nodose ganglion—was overlapping, and no well-demarcated regions in the nodose ganglion could be identified that received projections primarily from a given visceral organ. The motor nuclei providing parasympathetic (preganglionic) and somatic motor innervation to the viscera were primarily the dmnX, nA, and nRA. The entire dmnX (extending over 10–15 mm rostrocaudally), contributed fibers to each area injected with HRP, with the exception of the extrathoracic trachea. No region in the dmnX was found where preference was given to a specific viscus. The nA contributed efferents to all the viscera studied, and this contribution came from the entire 6 mm of nA contributing vagal efferents. Visceral containing smooth muscle as well as skeletal muscle were innervated by the nA. The caudal nRA provided motor fibers to the larynx, trachea, and stomach, and again no preferred rostrocaudal representation of motoneurons to a given viscus was found. Postganglionic sympathetic innervation to the viscera studied was found to be localized to the stellate and superior cervical ganglia. Within these sympathetic ganglia, some regional preference for different viscera was detected. In the case of motor innervation, unilateral paired viscera received motor fibers from both ipsilateral and contralateral sides of the medulla via both vagus nerves.

Brain stem projections of sensory and motor components of the vagus complex in the cat: I. The cervical vagus and nodose ganglion.

Abstract: The motor and sensory connections of the cervical vagus nerve and of its inferior ganglion (nodose ganglion) have been traced in the medulla oblongata of 32 adult cats with the neuroanatomical methods of horseradish peroxidase (HRP) histochemistry and amino acid autoradiography (ARG). In 14 of these subjects, an aqueous solution of HRP was applied unilaterally to the central end of the severed cervical vagus nerve. In 13 other cases, HRP was injected directly into the nodose ganglion. Three of these 13 subjects had undergone infranodose vagotomy 6 weeks prior to the HRP injection. A mixture of tritiated amino acid was injected into the nodose ganglion in five additional cats. The retrograde transport of HRP yielded reaction product in nerve fibers and perikarya of parasympathetic and somatic motoneurons in the medulla oblongata. Furthermore, a tetramethyl benzidine (TMB) method for visualizing HRP enabled the demonstration of anterograde and transganglionic transport, so that central sensory connections of the nodose ganglion and of the vagus nerve could also be traced. The central distribution of silver grain following injections of tritiated amino acids in the nodose ganglion corresponded closely with the distribution of sensory projections demonstrated with HRP, thus confirming the validity of HRP histochemistry as a method for tracing these projections. The histochemical and autoradiographic experiments showed that the vagus nerve enters the medulla from its lateral aspect in multiple fascicles and that it contains three major components--axons of preganglionic parasympathetic neurones, axons of skeletal motoneurons, and central processes of the sensory neurons in the nodose ganglion. Retrogradely labeled neurons were seen in the dorsal motor nucleus of X(dmnX), the nucleus ambiguus (nA), the nucleus retroambigualis (nRA), the nucleus dorsomedialis (ndm) and the spinal nucleus of the accessory nerve (nspA). The axons arising from motoneurons in the nA did not traverse the medulla directly laterally; rather, all of these axons were initially directed dorsomedially toward the dmnX, where they formed a hairpin loop and then accompanied the axons of dmnX neurons to their points of exit. Afferent fibers in the vagus nerve reached most of the subnuclei of the nTS bilaterally, with the more intense labeling being found on the ipsilateral side. Labeling of sensory vagal projections was also found in the area postrema of both sides and around neurons of the dmnX. These direct sensory projections terminating within the dmnX may provide an anatomical substrate for vagally mediated monosynpatic reflexes. Following deefferentiation by infranodose vagotomy 6 weeks prior to HRP injections into the nodose ganglion, a number of neurons in the dmnX were still intensely labeled with the HRP reaction product. The axons of these HRP-labeled perikarya may constitute the bulbar component of the accessory nerve.

A prospective randomized study of various irradiation doses and fractionation schedules in the treatment of inoperable non-oat-cell carcinoma of the lung. Preliminary report by the radiation therapy oncology group

Abstract: Preliminary analysis is presented of a prospective randomized study involving 365 patients with histologically proven unresectable non-oat-cell carcinoma of the lung treated with definitive radiotherapy. The patients were randomized to one of four treatment regimens: 4000 rad split course (2000 rad in five fractions one week, two weeks rest, and an additional 2000 rad in five fractions in one week) or 4000, 5000, or 6000-rad continuous courses in five fractions per week. Ninety to 100 patients were accessioned to each group. The one-year survival rate is 50% and the two-year survival rate, 25%. The patients treated with the split course have the lowest survival rate (10% at two years) in comparison with the other groups (range = 20–25%). The complete and partial local regression of tumor was 49% in patients treated with 4000 rad and 55% in the groups treated with 5000 and 6000 rad. For patients who achieved complete regression of the tumor following irradiation, the two-year survival rate is 40%, in contrast to 20% for those with partial regression, and no survivors among the patients with stable or progressive disease. The incidence of intrathoracic recurrence was 33% for patients treated with 6000 rad, 39% for those receiving 5000 rad, and 44–49% for those treated with a 4000-rad split or continuous course. At present, the data strongly suggest that patients treated with 5000 or 6000 rad have a better response, tumor control, and survival rate than those receiving lower doses. However, additional followup of patients at risk in each group will be necessary before a final conclusion is drawn. Patients with high performance status (Kornofsky index higher than 70), or with tumors in earlier stages (T1N2 or T3N0) have a two-year survival rate of approximately 40%, in comparison with 20% for other patients. The various irradiation regimens have been well tolerated, with complications being slightly higher in the 4000-rad split course group (10 severe and 2 life-threatening) and in the 6000-rad continuous course group (9 severe and 4 life-threatening). The most frequent complications have been pneumonitis, pulmonary fibrosis, and dysphagia due to transient esophagitis. Further investigation will be necessary before the optimal management of patients with bronchogenic carcinoma by irradiation is established.

Pharmacological regulation of calmodulin

Abstract: A number of psychotropic drugs, particularly the phenothiazines and related antipsychotic compounds, inhibit a variety of calmodulin-dependent enzymes. The mechanism by which these compounds inhibit the activity of calmodulin is through a selective calcium-dependent binding to this protein. With the notable exception of certain stereoisomers, compounds that are clinically effective antipsychotic agents showed the greatest degree of binding to calmodulin. Other classes of pharmacological agents, including aminergic agonists and antagonists, and nonspecific central nervous system depressants and stimulants, showed little or no binding to calmodulin. In fact, the specificity with which antipsychotic drugs bind to calmodulin suggests the possibility of screening for new and clinically more effective antipsychotic agents based on their selective binding to calmodulin. Certain neuropeptides that produce behavioral effects in animals also were found to inhibit the activity of calmodulin, suggesting that there may be endogenous psychotogens or antipsychotic peptides that interact with calmodulin. Although under ordinary conditions the binding of antipsychotics to calmodulin is reversible, the binding of phenothiazine antipsychotics to calmodulin can be made irreversible either photochemically by ultraviolet irradiation, or enzymatically by a hydrogen peroxide-peroxidase system. Such a labeling technique should prove to be a useful tool to study the localization and turnover of calmodulin. These results indicate that several of the diverse biochemical actions of antipsychotic agents can be explained by a common mechanism, namely, by their binding to and inhibition of calmodulin, and raise the possibility that calmodulin may serve as one of the cellular receptors for certain antipsychotic compounds. However, further studies must be completed before we can state with any degree of certainty that these in vitro biochemical findings can explain the pharmacological and clinical actions of the antipsychotics.

Dysesthesia after Mandibular Third Molar Surgery: A Retrospective Study and Analysis of 1,377 Surgical Procedures

Abstract: To statistically associate specific factors of surgical extraction of third molars with mandibular nerve dysesthesia, records of patients were reviewed for preoperative panoramic radiographs, complete operative and anesthetic records, preoperative and postoperative notes, and histories. Data were then tabulated and the cases of altered sensation were compared with cases of unaltered sensation.

Initiation and Growth of Transverse Cracks and Edge Delamination in Composite Laminates Part 1. An Energy Method

Abstract: This paper is concerned with the basic fracture mechanisms involved in matrix-dominated failures in fibrous composite laminates, Specifically, interlaminar fracture in the form of free-edge ply delamination and intra- laminar fracture in the form of multiple transverse cracks are investigated. In each case, a theory is formulated based on the classical linear fracture mechanics concept of strain energy release rate as a criterion for crack growth. A finite element technique incorporating the virtual crack-closure procedure is developed to generate numerical results. Simultaneously, an experimental study is conducted using a series of graphite epoxy laminates in the form of (±25/90n)s, n = 1,2,3. Part 1 of this paper presents the development of the method from the conceptual, physical and numerical considerations, while Part 2 provides for a comparison between the analyti cal and experimental results.

Capillary alterations in scleroderma

Abstract: Electron microscopy of capillaries was performed in scleroderma skin. The main alterations were (1) gaps, vacuolization and eventual destruction of endothelial cells, (2) reduplication of the basal lamina, (3) perivascular cellular infiltrates consisting of lymphocytes, plasma cells, macrophages, or monocytes, and (4) fibroblasts and pericytes with enlarged, rough endoplasmic reticulum (RER) accompanied by perivascular fibrosis. Perivascular cellular infiltrates and endothelial cell damage appear to precede the stage of fibrosis.

Initiation and Growth of Transverse Cracks and Edge Delamination in Composite Laminates Part 2. Experimental Correlation

Abstract: In part one of this paper, the fracture processes of multiple transverse cracking and free edge delamination in composite laminates have been analyzed by an energy method. Numerical analyses and experimental examination using a series of T300/934 graphite epoxy laminates are pre sented in this part two. While part one is presented in a self-contained form, part two must be regarded as the continuation of part one.

Technical Wording in Advertising: Implications for Market Segmentation:

Abstract: It may be ill-advised for advertisers to avoid technical language in print media messages directed to household consumers. Results of an experiment reported here suggest that technical wording leve...

Initial solar irradiance determinations from nimbus 7 cavity radiometer measurements.

Abstract: Preliminary results from solar radiation measurements from the earth radiation budget experiment on the Nimbus 7 satellite yield a mean value of 1376.0 watts per square meter for the "solar constant" from 16 November 1978 to 15 May 1979. The observed variability (root-mean-square deviation) is +/- 0.73 watt per square meter (+/- 0.05 percent) for the period.

The design and fabrication of thin-film CdS/Cu 2 S cells of 9.15-percent conversion efficiency

Abstract: Thin-film polycrystalline CdS/Cu 2 S cells with energy conversion efficiencies in sunlight of up to 9.15 percent and areas of ∼1 cm2have been developed. The improvement over previously achieved efficiencies is due to the development of techniques to separately measure and minimize fill factor losses. Specific design and fabrication changes based on a detailed quantitative analysis of the cell operation, were introduced to correct series resistance, shunt conductance and field effect losses. Further increases in efficiency can be expected from the development of a planar junction thin-film CdS/Cu 2 S cell.

Patterns of tumor recurrence after definitive irradiation for inoperable non-oat cell carcinoma of the lung.

Abstract: Preliminary analysis was carried out on a prospective randomized cooperative group study involving 375 patients with histologically proven unresectable non-oat cell carcinoma of the lung who were treated with definitive radiotherapy. The patients were randomized to one of four treatment regimens: 4000 rad split course (2000 rad in five fractions one week, two weeks rest and an additional 2000 rad, five fractions in one week) or 4000, 5000 or 6000 rad continuous courses, five fractions per week. 84 to 100 patients were accessioned to each group. The one year survival rate was about 40%; the two year survival rate was 10% to 18%. The patients who were treated with the split course had the lowest survival (10% at two years) compared with the other groups (14% to 18%). Complete and partial local tumor regression was 48 % in patients who were treated with 4000 rad, 65 % in the 5000 rad and 61 % in the 6000 rad group. The rate of initial intrathoracic recurrence was 38 % in patients who were treated with 6000 rad; 45 % in those who received 5000 rad, 51 % and 64 % with 4000 rad split or continuous course, respectively. Patients who showed complete or partial regression of the tumor following irradiation exhibited an initial local recurrence rate of 42 % and 46 % respectively in contrast to 57 % for those without tumor regression. Patients with epidermoid carcinoma had an initial local failure rate of 53%, adenocarcinoma and large cell undifferentiated carcinoma 41 %. Distant metastases concurrent with or prior to intrathoracic failure were significantly higher in the patients with adenocarcinoma or large cell adenocarcinoma (63%) than in epidermoid carcinoma (33%). The present data strongly suggest that patients who were treated with 5000 or 6000 rad had a better response, tumor control and survival than those who were treated with lower doses. Additional follow-up of patients at risk in each group will be necessary before a final conclusion is drawn. Further investigations should determine the impact that a variety of prognostic factors may have in efficacy of irradiation in patients with bronchogenic carcinoma. This information will be extremely useful in the design of future therapy for these various subpopulations of patients with different manifestations of the disease.

Myocardial bridging of the left anterior descending artery: evaluation using exercise thallium-201 myocardial scintigraphy.

Abstract: Seven patients with myocardial bridging of the left anterior descending coronary artery were evaluated by means of thallium-201 exercise scintigraphy. The degree of systolic narrowing was 60–70% in five patients and 75–80% in two patients. All patients had presented with chest pain. The resting electrocardiogram was normal in six patients; there were ST segment and T-wave abnormalities in one patient. No patient complained of chest pain during exercise. The exercise electrocardiogram was negative in six patients and inconclusive in one patient. Exercise myocardial scans were negative in all seven patients. We conclude that no evidence of ischemia was demonstrated in patients with myocardial bridging of the left anterior descending coronary artery as determined by exercise electrocardiography and stress thallium-201 scintigraphy.

Naturally occurring neuron death in the optic layers of superior colliculus of the postnatal rat.

Abstract: Application of light and electron microscopic techniques to the superior colliculus of the normal rat shows that a number of neurons die within the first week after birth. Cells in the earliest recognizable stages of degeneration are characterized by an overall increase in electron density and dilation of the intracellular cisternae, although there are only minimal changes in the chromatin pattern of the nucleus. Synapses are found on these cells. A second type of degenerating cell, with more striking changes in the nucleus, also appears in the tissue but very infrequently. In later stages of degeneration, cells are reduced to a condensed chromatin mass surrounded by disrupted fragments of the rest of the cell. This ‘cellular debris’ is found within glial cytoplasm. The majority of these debris profiles appear in the first postnatal week and are usually most abundant in the caudal third compared to either the rostral or middle thirds of the colliculus. The results suggest that the mechanisms controlling neuron number in the superior colliculus are operative in the postnatal rat but argue against a simple relationship between the survival of a particular neuron and the total number of optic connections that neuron has received.

Binocularity in the cat visual cortex is reduced by sectioning the corpus callosum

Abstract: In the normal cat, most cells in area 17 can be binocularly driven. Sectioning the corpus callosum results in a significant reduction in binocularly driven cells. Normal binocular vision is thus dependent on the corpus callosum.

Merits of stress thallium-201 myocardial perfusion imaging in patients with inconclusive exercise electrocardiograms: correlation with coronary arteriograms.

Abstract: Stress thallium-201 myocardial perfusion images were obtained in 65 patients with an inconclusive exercise electrocardiogram. All 65 patients underwent coronary angiographic studies. The exercise electrocardiogram was judged inconclusive in 35 patients (54 percent) because submaximal exercise had been performed and in 30 patients (46 percent) who manifested ST-T segment abnormalities at rest. Exercise thallium-201 myocardial perfusion images were abnormal in 20 patients and normal in 45. Nineteen (95 percent) of the 20 patients with abnormal exercise images had severe disease of one or more major coronary arteries. Thirty-seven (82 percent) of the 45 patients with normal exercise images had no significant coronary artery disease; the remaining 8 patients had coronary artery disease. Therefore, 19 of 27 patients with coronary artery disease had abnormal exercise images (sensitivity 70 percent), and 37 of 38 patients without coronary artery disease had normal exercise images (specificity 97 percent). Thallium-201 imaging predicted the correct diagnosis in 56 patients (86 percent). Thus, exercise myocardial imaging with thallium-201 appears to be a useful diagnostic aid in patients with an inconclusive exercise electrocardiogram.

Seizure disorders following periodic lateralized epileptiform discharges.

Abstract: Summary: We reviewed 3,436 EEGs and found 24 patients with periodic lateralized epileptiform discharges (PLEDS). The etiology was unknown in 7, cerebrovascular occlusion in 7, tumor in 3, intracerebral hematoma in 2, and subdural hematoma, neonatal asphyxia, electrolyte imbalance, subarachnoid hemorrhage, and hypoglycemia in each of the remaining cases. We were successful in contacting 18 patients and/or their families for follow-up. Twenty of the 24 patients with PLEDS had seizures. Seven had focal motor alone, 10 had focal motor with secondary generalization, and 3 had generalized seizures without any observed focal features. Four patients had no seizures. Twelve patients had their first seizure at the time PLEDS were found. Fifteen adults and 3 infants were reevaluated. Only 1 adult was functionally independent. The 3 infants evidenced developmental delay. Six adults had seizures prior to the observation of PLEDS, and 5 (83%) of them reported seizures after hospitalization. Nine of the 15 adults had their first seizure associated with PLEDS, 6 of whom (67%) also reported seizures after hospitalization. In 9 patients with serial EEGs during their hospitalization, PLEDS disappeared within 22 days. We concluded that most patients with PLEDS and concomitant seizures continue having seizures after hospitalization and need antiepileptic medication. RESUME Les auteurs ont trouve 24 fois des decharges epilep-tiformes periodiques lateralisees (PLEDS) sur 3.436 traces examines. L'etiologie etait sept fois inconnue et concernait les autres fois: une occlusion vasculaire cerebrale (7 cas), une tumeur (3 cas), un hematome intracerebral (2 cas), une epilepsie neo-natale, un trouble de l'equilibre electrolytique, une hemorragie sous-arachnoidienne et une hypoglycemie (1 cas respec-tivement). L'evolution de l'affection a pu etre connue pour 18 des 24 patients. Vingt patients sur vingt quatre ont presente des crises. Sept fois focales motrices isolees, dix fois focales motrices avec generalisation secondaire, trois generalisees sans symptomatologie focale apparente. Douze patients avaient leur premiere crise au moment oil les PLEDS ont ete trouves. Quinze adultes et trois enfants ont ete revus. Les trois enfants montraient un retard du developpement. Un seul adulte etait fonctionnellement independant. Six adulte avaient des crises avant l'apparition des PLEDS et cinq (83%) d'entre eux en presentaient encore apres l'hospitalisation. Neuf des quinze adultes ont eu leur premiere crises en me me temps que les PLEDS et 6 d'entre eux (67%) en presentaient encore apres l'hospitalisation. Chez neuf patients ayant eu des EEG repetes pendant leur hospitalisation les PLEDS ont dis-paru dans un delai de 22 jours. En conclusion les auteurs admettent que la plupart des patients qui presentent des PLEDS et des crises concommitantes continued a presenter des crises apres leur hospitalisation et doivent recevoir un traitement anti-epileptique. RESUMEN Revisamos 3.436 EEGs encontrando 24 pacientes con descargas epileptiformes periodicas lateralizadas (PLEDS). La etiologia fue desconocida en 7 enfermos, habia una oclusion cerebrovascular en 7, un tumor en 3, un hematoma intracerebral en 2 y un hematoma subdural, asfixia neonatal, anomalias electroliticas, hemorragia subaracnoidea e hipoglucemia en cada uno de los restantes casos, respectivamente. Tuvimos exito contactando con 18 pacientes y/o sus familias con propositos de revision. Veinte de los 24 enfermos con PLEDS tuvieron crisis. En 7 las crisis solo fueron motoras, 10 tuvieron crisis motoras focales con generalizacion secundaria y 3 tuvieron ataques generalizados sin que se observaran signos focales. Cuatro pacientes no tuvieron ataques. Doce enfermos tuvieron el primer ataque al mismo tiempo que se observaron PLEDS. Se re-evaluaron 15 adultos y 3 ninos. Solo 1 adulto era funcionalmente independiente. Los 3 ninos mostraron retraso en el desarrollo. Seis adultos mostraron crisis antes de que se observaran las PLEDS y 5 de ellos (83%) informaron que habian tenido ataques despues de la hospitalizacion. En 9 enfermos que tuvieron repetidos EEGs durante su hospitalizacion, las PLEDS desaparecieron antes de los 22 dias. Nuestra conclusion fue que la mayoria de pacientes con PLEDS y crisis comiciales concomi-tantes continuaron teniendo ataques despues de su hospitalizacion y necesitaron medicacion anticomicial. ZUSAMMENFASSUNG Wir sahen 3436 EEG durch und fanden 24 Patienten mit periodischen lateralisierten epileptiformen Ent-ladungen (PLEDS). Die Atiologie war bei 7 unklar, 7 hatten cerebrovaskulare Verschlusse, 3 einen Tumor, 2 ein intracerebrales Hamatom, je einmal wurden ein subdurales Hamatom, eine neonatale Asphyxie, eine Elektrlytstorung, eine subarachnoidale Blutung und eine Hypoglykamie gefunden. 18 Patienten konnten erreicht und sie oder ihre Familien verfolgt werden. 20 der 24 Patienten mit PLEDS hatten Anfalle: 7 nurfokal motorische, 10 fokal motorische mit sekundarer Generalisierung und 3 generalisierte Anfalle ohne fokale Symptome. 4 Patienten hatten keine Anfalle. 12 Patienten hatten ihren ersten Anfall zum Zeitpunkt, an dem PLEDS gefunden wurden. 15 Erwachsene und 3 Kinder wurden kontrolluntersucht. Nur 1 Er-wachsener war funktionell unabhangig. Die 3 Kinder zeigten eine Entwicklungsverzogerung. 6 Erwachsene hatten Anfalle vor dem Zeitpunkt, an dem PLEDS beobachtet wurden und 5 (83%) von ihnen berichteten uber Anfalle nach der Hospitalisierung. 9 der 15 Er-wachsenen hatten ihren ersten Anfall zum Zeitpunkt der PLEDS, 6 von ihnen (67%) auch Anfalle nach der Hospitalisierung. Bei 9 Patienten mit me h re re n EEG-Untersuchungen wahrend der Hospitalisierung verschwanden die PLEDS innerhalb 22 Tagen. Wir schlossen, das die meisten Patienten mit PLEDS und begleitenden Anfallen weiterhin Anfalle nach Hospitalisierung haben und eine antiepileptische Medikation benotigen.