It is a general rule today, after a relevant diagnostics of an epilepsy, to start a monotherapy treatment, depending on a kind of a seizure, a life age and a general health condition. First line of monotherapy epilepsy drugs remain carbamazapine and sodium valproat. New drugs that are being introduced are: felbamat, gabapentin, lamotrigin, oxcarbazepin, tiagabin, topiramat, vigabatin and zanisamid. These are commonly used as add-on therapy, or as an addition for previously used antiepileptic. Their indicated areas are complex resistant partial seizures with or without generalization. Attention should be paid on proper dosage, interactions and toxicity. Regardless on the new epileptic era, according to reports of International League against epilepsy, most of the patients do not receive the drug that is the most appropriate for them concerning the price (cost-benefit). Neurosurgical methods in epilepsy treatment are: selective amygdalo-hyppocampotomy, temporal lobotomy, subpial resection, hemispherectomy, corpus callosotomy, removal of lesions like tumors or cysts provide encouraging results in reduction of epileptic seizures that can be followed by reduction of drug therapy. N. vagus stimulation is being wider introduced in resident epileptics. Treatment of epilepsy in women requires an approach to sexuality, conception, pregnancy, introduction of medicaments, antiepileptic terratogenity, contraception, motherhood and menopause. A special significance of modern approach to epilepsy is in treatment of elderly who have cerebrovascular and neurodegenerative disease as a cause of seizures. A complex treatment of epilepsy using pharmacological and neurosurgical approach requires supportive psychotherapy, socio-therapy, the work with a family, education about epilepsy and living a life with more quality having one.

A seizure is a disturbance of movement, feeling or consciousness occasioned by sudden, inappropriate and excessive electrical discharges in the grey matter of the brain. The most common psychiatric disorder in epilepsy is interictal depression, with lifetime prevalence of 40 to 60%. Particular attention should be paid to suicidal ideations, due to the fact that most of the patients have easy access to potentially lethal when overdosed, antiepileptic drugs. The aim of our paper is to determine the presence of depressive symptoms in epileptic patients according to their treatment protocols (monotherapy or polytherapy), gender, age, social status, age when diagnosed, type and frequency of seizures. Prospective evaluation of monotherapy and polytherapy in 60 subjects, (30 subjects in each group), who were diagnosed with epilepsy. Assessment of depressive symptoms was performed with the use of BDI scale. In both groups there was a similar structure according to gender, mean age was 34 (with an s.d. of 11.06). More than 96 percent of the subjects had low or average socioeconomic status. Average age of first attack was 20.43 (with an s.d. of 11.9). In the group treated with monotherapy there was the biggest number of generalized convulsive seizures, and in the group treated with polyantiepileptic therapy there was the biggest number of partial complex seizures. Symptoms of moderate and severe depression were registered in 33% patients treated with monotherapy and 60% of patients treated with polytherapy (t = 2.198, for p less than 0.05). 16.7 percent of the patients had suicidal ideation. On the basis of our research we can conclude that significantly more frequent and severe depressive symptoms were found in the group of epileptic patients who were treated with polytherapy. In those patients the occurrence of partial complex seizures was the biggest, and their frequency was weekly or even daily.

UNLABELLED The state of mental confusion is described as an dependent risk factor in development of early and late epileptic-onset seizures following CVI. The aim of this paper is to determine the influence of confused state as possible predictor of symptomatic seizures in the course and following CVI. MATERIAL AND METHODS The patients who were treated in The Department of Neurology for early and late-onset seizures in the course and following CVI in the period between 1.1.1989 and 31.12.1998. RESULTS We had total number of 106 patients with symptomatic seizures, 56 in the group of late-onset and 50 in the group of early seizures. 52.8% of the patients have a registered state of mental confusion at the admission to hospital (in the stage of acute CVI), 19.2% of patients had a clear sensorium. Disorder of consciousness of the type of coma was registered in 27.4% of the patients. There was statistically significant increase of the occurrence of mental confusion in the group of patients with late-onset seizures, 62.5% while there was a statistically significant increase of coma in conditions related to type, frequency and outcome of seizures. We can conclude that mental confusion has significant influence of the occurrence of late-onset seizures while it does not influence the type and frequency of seizures.

Data was analyzed retrospectively of a ten year period at the Neurology clinic in Sarajevo, with regards to the treatment of patients with acute cerebrovascular accident (CVA or stroke). The whole period has been divided into three segments: a) pre-war period 01.01.1990-05.04.1992, b) the war period 06.04.1992-15.12.1995, and c) post-war period 16.12.1995-31.12.1999. There has been the total of 6,255 patients with a completed stroke, while the patients with transitory ischemic attacks were not involved in the study. General mortality from stroke rose considerably during the war, the rate is somewhat reduced post-war, but not as low as pre-war (35%, 48%, 38% respectively). During the war there was a greater number of patients with intracerebral haemorrhage compared to the atherothrombotic brain infarction group, but the relationship changed after the war in favor of the latter. No difference in sex structure was noticed in the observed three periods. During the war, there was 0 minor increase in the percentage of patients in the 51-60 years age group, but after the war there was a remarkable increase in the 70+ age group. As far as risk factors are concerned, we have traced a marked raise in rates of the hypertension and cardiopathy during the war, with a lower frequency of diabetes. The first two risk factors have kept the same trend post-war, and diabetes returned to the its approximately pre-war level. All changes described here are pointing towards a remarkable influence of war activities on morbidity and mortality of the cerebrovascular accident, where the rates are slowly and incompletely returning to its pre war levels.

The Neoplasms are the second leading cause of the mortality of the adult according to WHO. The last decade is the decade of the increase of all the epidemiologic parameters of the neoplasms in general, so also the neoplasms of the central nervous system. The goal of the work was to realize the frequency of the appearance of the neoplasms of the CNS on the clinical material of the Neurologic clinic CC University of Sarajevo with the special accent on the influence of the war as the specific stressor and the factor sui generis at the epidemiologic parameters of the neoplasms of the CNS. The study is retrospective: it is comprehended the period from the 1st January 1990 till 31st December 1999 year. The patients have been analyzed according to years, according the kind of the neoplastic processes and according to the time periods. At the analyzed period was treated 10,329 patients per year, according to the kind of the neoplastic processes and according to the time periods we evidenced the mild decrease from 1991-1999 year (3.03%-2.44%). According to the sex we register 167 males (60%) and 116 females (40%). The most frequent occurrence is in the age period from 55 to 69 years (55% patients). Of the primary neoplastic processes we had in 178 patients (64), with metastases 105 patients (36%). We analyzed the time periods: the prewar period (1st January 1990-5th April 1992), the war period (6th April 1992 till 14th February 1955), and the postwar period (15th December 1995 till 31st December 1999 year). The primary neoplasms in the postwar period we had in 70 patients (40%), in the course og est 35 patients (20%) and after war 69 patients (40%). The metastatic processes are in the evident increase during the war and after the war: before the war 19 patients (18%), during the war 32 patients (31%) and after the war 54 patients (51%). In the collected material during the war and after the war was evidenced the increase of the primary neoplastic processes at the lungs and other organs which have methastized at the nervous system. On the basis of our examination we can conclude that the total clinical material was present the mild percentage decrease of the neoplasms in the relation to all other admitted patients. The primary neoplastic process have been equally present in the patient material before and after the war with certain decrease during the war (probably because of the war and the reduced diagnostics). It is noticed the significant increase of the metastatic processes of the nervous system during the war and after the war. We are of opinion that the increase of the metastatic processes during the war and after the war is more many fold conditioned: the conditions of life of people during the war, shellings, fright from death and wounding, mourning for the killed and the wounded members of the most narrow family, the weak and inadequate nutrition, the increased smoking of the cigarettes, decrease of the total immune forces of an organism and others.

The facial nerve has predominantly the motoric, and less sensitive function and gets nerved the muscle musculature of the face and its damages, significantly disturbs the function of the series of the muscles of the face. Regarding to this that the parases of the nervus facialis are often in the physician practice, we have written this article with aim to facilitate to the physicians in the practice the early establishing of the diagnosis, and also to give the instructions into the basic physical and rehabilitation procedures which is with success to carry out in patients with the damages of this nerve.