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Multiple Sclerosis (MS) is the most common, primary neurogenic cause of disability among young adults. We investigated demographic and clinical factors associated with unemployment on the example of 150 MS patients receiving immunomodulatory treatment in Poland. This study was based on clinical evaluation and collection of self-reported questionnaires, with an attention to self-motivation, severe fatigue and moderate disability. Patients who were unemployed (40% of all patients) had a mean disease duration of almost 5 years. Older (p<0.001), less educated (p = 0.007) and more severely disabled patients (p<0,001) were most likely to be unemployed. Moderate disability (OR = 11.089 95% CI: 4.11-34.201, p<0,001), severe fatigue (OR = 2.625 95% CI: 1.02-6.901, p = 0,046) and lower level of self-motivation (KNS) (OR = 0.947, 95% CI: 0.896-0.006, p = 0.042) were independently associated with unemployment.

Objective: Thrombolysis is a time-dependent therapy. It is therefore very important how fast stroke patients can reach hospital. The present study was designed to assess which proportion of patients with stroke (from the population of Szczecin, the capital of West Pomerania Province, Poland) reaches hospital within the recommended time from the thrombolytic therapy point of view. The purpose of our study was also to elucidate which factors can influence the time before the ambulance service is called., Patients and Methods: The study involved 1,015 patients with stroke admitted to the Emergency Department of the University Hospital, Szczecin., Results: 235 patients (23.1%) were admitted to the hospital within the appropriate period for thrombolytic therapy. Hospital arrival time was significantly earlier in older patients and in patients with severer neurological deficits. We also observed a tendency for faster hospitalization of women, the highly educated, and patients regularly using antiplatelet drugs for cardiovascular disease prevention., Conclusions: The percentage of stroke patients hospitalized within 2 h after stroke onset should be increased. The most susceptible subpopulations in our country seem to be older patients, the highly educated and patients regularly using antiplatelet drugs for cardiovascular disease prevention., (2007 S. Karger AG, Basel)

The objective of the present study was to quantitatively detect axons in the minute multiple sclerosis (MS) lesions and in shadow plaques, taking into consideration the relapsing-remitting(R-R) and secondary progressive(SP) stages of MS. The brain tissue of 12 patients deceased due to MS was investigated. An image-computerized analysis was made for measurements of axons. Based on the findings we concluded that damage to axons appears in both the minute MS lesions and in shadow plaques. Demyelination and ineffective (too late or too slow) remyelination seemed to be very important factors in axonal damage. Irreversible damage to axons may appear in both the secondary progressive and relapsing-remitting stages of MS, causing permanent neurological deficits, irrespective of the duration of the disease.

Among 100 patients with MS, in 65 patients CT examination revealed cerebral atrophy (in 58 cortical and subcortical atrophy, in 7 patients only cortical). In 25 (25%) patients with cerebral atrophy EEG findings were focal type of paroxysmal activity. Only five patients with paroxysmal discharges had epileptic fits. Mean age in these 5 patients was 47 years, mean duration of the disease 17 years. This means that seizures in MS patients appeared in late period of the disease and no correlation was between cerebral atrophy and epileptic seizures. Paroxysmal discharges occurred more often in EEG examination, than clinical seizures.

The study included 55 patients (18 females, 37 males); aged 32-75 yr. who divided into three groups according to the severity of clinical picture: 12 people with reversible ischaemic stroke (RIS), 20 with progressive ischaemic stroke (PIS), 23 with complete stroke (CS). Levels of total cholesterol, high density lipoproteins (HDL), apolipoproteins A1 and B (ApoA1 and ApoB), fibrinogen (Fb) and Lp (a) were measured. Lipid factor of atherosclerosis (ATHi) was quantified. Qualitative evaluation of lipids contents in cerebrospinal fluid (CSR) was performed. Distribution of cholesterol--containing lipids among the fractions, despite low values, had clearly atherogenic profile. 12% patients with irreversible ischaemic stroke, 16% with progressive ischaemic stroke and 85% with complete stroke had Fb level above 4 g/l. Lp (a) levels in all cases were significantly higher in the cells isolated from CSF. The severity of the stroke correlated with increasing levels of lipids in the cells isolated from SF. There was correlation between LDL cholesterol and content of lipids in the cells from CSF.

A high incidence of epilepsy in chronic alcoholics and similar incidence of alcohol abuse in patients with epilepsy are a serious medico-social problems. A relation between seizures and alcohol abuse is discussed in this paper. Epilepsy is the commonest complication of an alcoholism. Pathogenesis of epileptic seizures is multiple and complex. Alcohol-dependent epilepsy is closely related to a problem of alcohol abuse in patients with epilepsy. A criteria of alcohol-dependent epilepsy diagnosis should be clearly defined as they play an important role in therapy selection.

The authors report two cases of neoplastic encephalopathy. In one patient with oviduct carcinoma it had the form of cerebellopathy. In the other case of renal carcinoma it appeared as encephalopathy with a nearly exclusive involvement of cerebral hemispheres. The reaction of microglia, lymphocytes and diffuse demyelination found in these cases are regarded by the authors as a result of autoimmunization in the course of malignant neoplasm. Attention is called to the importance of axial computer tomography in the intravital diagnosis of this encephalopathy.