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Numerous antibiotics may trigger epileptic seizures or status epilepticus by decreasing inhibitory transmission in the brain, thus lowering the seizure threshold. The most potent seizurogenic effect is exerted by penicillins, cephalosporins, fluorochinolons and carbapenems. Predisposing factors that facilitate development of epileptic seizures in the course of antibiotic therapy comprise all conditions accompanied by damage to the blood-brain barrier (including cerebral trauma and encephalitis), a high dose of an antibiotic or lack of adequate dose adjustment in patients with renal failure. A particularly dangerous and difficult to diagnose complication is nonconvulsive status epilepticus in patients treated with cephalosporins. For this reason, in case the patient presents with alterations of consciousness in the course of cephalosporin therapy, an EEG test should be performed. Some antibiotics, such as carbapenems, macrolides and antitubercular medications enter into pharmacokinetic interactions with antiepileptic agents, causing a decrease or increase in the plasma concentration of the latter and in consequence lead to possible epileptic seizures or drug-associated neurotoxicity. In patients with risk of epileptic seizures or with diagnosed epilepsy, one should select an antibiotic with a low proconvulsive potential and administer it in an adequately adjusted dose, especially in individuals with renal failure. Employing antibiotics interacting with antiepileptic medications with which the patient is treated should be avoided.

Except for pharmacotherapy--electroconvulsive treatment ECT is the most important therapy form of depressive disorders. Although ECT elicits a paroxysmal activity in the brain, the convulsive electric stimulation ECT leads however at least to a anti-convulsive effect (e.g.: elevation of the threshold level). The submitted work undertakes a trail of analysis about kindling-another neurophysiological mechanism. This phenomenon was described in sixties of the 20th century and depends on inducing of spontaneous paroxysmal activity as a result of the subthreshold brain stimulation. The same effect is taken as one of the (possible) basic pathomechanisms not only of epilepsy, but also of some psychiatric disorders., e.g. depression (or affective disorders). On the second hand--the ECT is a suprathreshold stimulation and should not be able to produce the process of kindling. Some doubt in the possibility of kindling occurrence in the human species. The work discusses the possible relationships between physical therapy such as ECT and the phenomenon of kindling, as well as it presents their possible implications.

Introduction: Cavernous hemangioma is increasingly recognized as the cause of epilepsy attributed to vasogenic foci. The clinical picture of this lesion is notable for epileptic seizures and intracerebral hemorrhage. Surgical excision of cavernoma remains the most effective antiepileptic modality. Good results of surgery are achieved with the use of modern operative procedures such as stereotaxy and neuronavigation., Material and Methods: Twelve patients with cavernous hemangioma were operated at the Department of Neurosurgery and Pediatric Neurosurgery, Pomeranian Medical University, Szczecin, between 1999 and 2008. This group included 10 females aged 7-54 years (mean 24.8 years) and 2 males aged 14-49 years (mean 31.5 years), 7 children (58.3%) and 5 adults (41.7%). Seven patients (58.3%) presented with generalized and the remaining 5 patients (41.7%) with secondarily generalized seizures. The mean time from onset of seizures to surgery was 2.6 months. All patients were operated using preoperative neuronavigated mapping to determine the optimal access to the lesion followed by neuronavigation-guided cavernoma excision. Postoperative neurological status was assessed with GOS scale and antiepileptic treatment outcome with Engel's scale as modified by Moran., Results: The caveroma was completely removed in each case. Postoperative follow-up time was 2-59 months (mean 30.3 months). Neurological status of all patients was category 5 of the GOS scale. Engel's class I outcome was achieved in all patients. Nine patients (75%) were weaned off antiepileptic drugs following normalization of EEG., Conclusions: The following conclusions were drawn basing on the findings of this study: (1) Neuronavigation offers high precision and low traumatization which reduce the risk of neurological sequellae (neurological deficits and epilepsy) in patients operated for cavernoma; (2) Early resection of cavernoma offers the chance of curing epilepsy.

The seizures which accompany specified situations occur in about 5% of population. They are frequent in patients at developmental age due to a different degree of brain maturity. A single, occasional seizure event which occurs in specified situations is not an epilepsy but it constitutes a significant clinical problem which requires a thorough diagnostics and procedure. We discuss situation-related seizures (also called acute symptomatic seizures) in children, excluding febrile convulsions. We bring attention to situation-related seizures characteristic only of developmental age.

Epilepsy is one of the most frequent neurological disorders, both in children and adult persons. About 0.5-1% of general population suffer from epilepsy, which means that about 50 million people in the world are affected. First years of life and very late adulthood are periods in human's life particularly predisposing to epilepsy. Repetitive epileptic seizures may cause many life-threatening situations and significantly lower patient's quality of life. To the most serious complications belong status epilepticus and sudden unexpected deaths due to epilepsy (SUDEP). Absences from work or school caused by seizures, difficulties in social life, frequent injuries and necessity of polytherapy are also important for patients. All these factors result in low self-esteem and poor quality of life. The main aim of the treatment was control of epileptic seizures. However, despite of new antiepileptic drugs developed almost every year, in one third of all patients with epilepsy seizures remain out of control. Those patients are regarded to have "drug-resistant epilepsy". Despite of significant scale of the problem, there is no one definition of the phenomenon. In the presented review the authors outline current definitions, recent opinions on pathogenesis and risk factors, and provide practical rules of pharmacotherapy of epilepsy, which should help to restrict drug-resistancy.

Aim: Presentation of two cases of children with Rasmussen's encephalitis, treated by functional hemispherectomy. Two boys aged 4 and 6, with a typical clinical course, typical findings in CT and MRI scans and characteristic pathologic changes in brain specimens. In both cases was performed functional hemispherectomy., Results: Immediate cessation of seizures in the immediate postoperative period (Engel class I and II). Later, in a 4-months' follow-up period, a worthwhile improvement in psychomotor development and social functioning was noted. Up-to date opinions published in available literature, related to pathogenesis and treatment modalities of Rasmussen's encephalitis are presented., Conclusions: 1) Rasmussen's encephalitis is a definite nosologic entity, leading to drug-resistant epilepsy and a progressive psychomotor deterioration; 2) functional hemispherectomy is a viable alternative, which should be considered in the treatment of Rasmussen's encephalitis; 3) Functional; hemispherectomy, in spite of it's aggressiveness, is a relatively safe procedure; 4) in the follow-up time of 4 months, the results are promising.

Spontaneous intracranial hematoma is not rare, but with bad prognosis, complication in patients on maintenance hemodialysis (HD). Diagnostic difficulties result from a fact that symptoms of acute hematoma such as headaches,, nausea, vomitis, apathy, sleepiness, parestesia and seizures may also suggest dysequilibrium syndrome, dialytic dementia as well as hypertensive encephalopathy. We describe a case of female patient with 20-year interview data of hypertension on HD since 1981 because of end-stage renal failure in a course of chronic glomerulonephritis, who developed spontaneous epi- and subdural hematoma four year ago in 47 age of life. Performed CT examination confirmed diagnosis and on the same day the patient underwent right frontoparietotemporal craniotomy and the hematoma was removed. During postoperative period, HD sessions were performed without heparin. After surgery the patient developed transcient hypertonia, epileptic sizures and left-sided paresis. Currently, 48 months after craniotomy the patient is fully rehabilitated, with normal blood pressure, without epileptic sizures or palsy. Gradually we discontinued anticonvulsans and antihypertensives.