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Abstract Juvenile myoclonic epilepsy (JME) is a common idiopathic generalised epilepsy with variable seizure prognosis and sex differences in disease presentation. Here, we investigate the combined epidemiology of sex, seizure types and precipitants, and their influence on prognosis in JME, through cross-sectional data collected by The Biology of Juvenile Myoclonic Epilepsy (BIOJUME) consortium. 765 individuals met strict inclusion criteria for JME (female:male, 1.8:1). 59% of females and 50% of males reported triggered seizures, and in females only, this was associated with experiencing absence seizures (OR = 2.0, p

IntroductionDevelopmental and epileptic encephalopathies (DEE) is a group of epilepsies where the epileptic activity, seizures and the underlying neurobiology contributes to cognitive and behavioral impairments. Uncovering the causes of DEE is important in order to develop guidelines for treatment and follow-up. The aim of the present study was to describe the clinical picture and to identify genetic causes in a patient cohort with DEE without known etiology, from a Norwegian regional hospital.MethodsSystematic searches of medical records were performed at Drammen Hospital, Vestre Viken Health Trust, to identify patients with epilepsy in the period 1999–2018. Medical records were reviewed to identify patients with DEE of unknown cause. In 2018, patients were also recruited consecutively from treating physicians. All patients underwent thorough clinical evaluation and updated genetic diagnostic analyses.ResultsFifty-five of 2,225 patients with epilepsy had DEE of unknown etiology. Disease-causing genetic variants were found in 15/33 (45%) included patients. Three had potentially treatable metabolic disorders (SLC2A1, COQ4 and SLC6A8). Developmental comorbidity was higher in the group with a genetic diagnosis, compared to those who remained undiagnosed. Five novel variants in known genes were found, and the patient phenotypes are described.ConclusionThe results from this study illustrate the importance of performing updated genetic investigations and/or analyses in patients with DEE of unknown etiology. A genetic cause was identified in 45% of the patients, and three of these patients had potentially treatable conditions where available targeted therapy may improve patient outcome.

Introduction: Hereditary ataxia is a group of rare, progressive genetic disorders that affects the neurological system and, in particular, the cerebellum. It results in poor coordination of movement and gait. As there is no curative treatment for hereditary ataxia, physiotherapy is essential for maintaining function and quality of life. Main part: Hereditary ataxia arises secondary to mutations/disease causing variants in a single gene that causes damage to the nervous system. Over 100 different genetic forms of hereditary ataxia have been described if all forms and syndromes are included. Research with new family cohorts continues to identify new forms every year. Patients who have been diagnosed with hereditary ataxia should be offered a comprehensive program of physiotherapy. Individualized assessments and therapy plans are needed because hereditary ataxia is a large and heterogeneous group of diseases. Such a physiotherapy plan aims to teach practical strategies to cope physically with activities of everyday life and includes the use of orthopedic and technical aids and adaptation of the environment. It also aims to maintain and improve function through a focus on balance, coordination, and strength using more specific exercises and training. It is important that the physiotherapist has in-depth knowledge about the diagnosis and collaborates effectively with doctors and other professional in order to provide the most beneficial care. Conclusion: Physiotherapy is an important component for the management of the physical effects of Hereditary Ataxia.

Introduction: Dystonia is a neurological condition which leads to involuntary muscle contractions and is little known among physiotherapists and doctors. Main part: Dystonia can affect people of all ages and can be caused by various brain diseases, various hereditary factors or unknown factors. Dystonia is a medical term both used as a symptom and a disease group. Dystonia can be a single symptom, isolated dystonia, or together with other neurological symptoms and is then called combined dystonia. The largest group of dystonia is isolated dystonia which often affects the neck muscles with involuntary, spasm-like movements and gives troublesome twisting movements of the neck. Many patients with dystonia get a wrong diagnosis such as; «crick in the neck» or muscle tension and many go undiagnosed and untreated. Summary: It is important to recognize dystonia, because then the patients can receive proper treatment, both in terms of Botulinum toxin treatment and physiotherapy. With proper treatment, patients can return to work, have significantly less pain and a better functioning.

This article reports findings from a comparative study of the influence of values and norms on the delivery of administrative and professional services in the public sector at the local government level in three selected countries in the Baltic Sea Region, Latvia, Lithuania, and Norway. The research concerns the criteria that professional welfare and health professionals apply in individual cases whenever they are expected to make high-quality judgments regarding the care of older people. The research question seeks to explore whether there are significant differences with regard to the effect of formal rules and norms on the effort to arrive at good solutions in providing public services in three democracies, one long-established and two recent. The results of this study show that in making their decisions, professionals in all countries emphasize the necessity of considering a broad range of legal and professional norms. For all respondents these considerations – in varying degrees of intensity – rank ahead of economic and administrative concerns.