Læknablaðið : fylgirit - 01.05.2002, Page 25

ABSTRACTS / 33RD SNC & 2ND SCNN
fied. There are FHM families not linked to either chromosome 19
or 1 and thus at least a third gene locus exists.
Heterogeneity is also very likely for the more common entities,
migraine with and without aura. The female preponderance of mig-
raine could suggest involvement of X-chromosome. Indeed, Nyholt
and colleagues have found, in two large multigenerational migraine
pedigrees, significant excess allele sharing of Xq in typical familial
migraine. Peroutka and colleagues reported overrepresentation of
DRD2 IC allele of the D2 dopamine receptor gene (in chromo-
some 11) among patients with migraine with aura. In Sardinia, Del
Zompo and colleagues demonstrated a positive association bet-
ween allele 1 of the same dopamine receptor gene in migraineurs
with both jawning and nausea during allacks. Dopaminergic candi-
date genes have thus also been in the spotlight. Tlie CACNAIA
gene has been connected also to migraine with and without aura in
association analyses. Further evidence was demonstrated by Ter-
windt and colleagues, who found increased allele sharing in the
region in affected siblingpairs, especially in pairs with migraine with
aura.
Recently even more genomic areas have been studied. Nyholt
and colleagues linked typical migraine in an Australian family to
chromosome 19pl3 with evidence for genetic heterogeneity. An
insuline receptor gene on 19pl3.3/2 and an endothelin type A
receptor gene are among the hot new topics. Lea and collegues
have found linkage and association to lq31 in 83 Australian pedi-
grees. Most recently, in 50 extensive Finnish migraine families,
Wessman and collegues found susceptibility locus for nonhemi-
plegic migraine with aura on chromosome 4q24. These novel dis-
coveries clearly underly the complexity and heterogeneity of mig-
raine with and without aura.
L19 - Botulinum toxin treatment from the clinician’s point of
view
Jakobsson F
Dept. of Neurology, Landspítali University Hospital Grensás, Reykjavík, Iceland
Abstract not received.
L20 - Botulinum toxin and hyperhidrosis.
Naver H, Aquilonius S-M
Department of Neuroscience, Neurology, Uppsala University Hospital Sweden
In 1822 Justus Kerner described muscular paralysis as well as anhid-
rosis in botulism. (Kerners disease). In 1996 treatment of focal
hyperhidrosis with botulinum toxin was developed in Uppsala, and
since 1997 the therapy has replaced sympathectomy for severe
palmar hyperhidrosis. The anhidrotic effect lasts long as compared
to the effect on dystonia, side effects are minor and transient. For
axillary hyperhidrosis the safety and efficacy of btx has been
confirmed in two multicentre double blind placebo controlled
studies. Frey syndrome and secondary and primary hyperhidrosis at
other locations may be treated with similar good results
Our demonstration that the severely reduced quality of life of
hyperhidrotic patients can be restored, that side effects are transient,
that the therapy can be performed by nurses, motivates that the
therapy should be offered these patients before sympathectomy.
L22 - Epidemiology of epilepsy in lceland
Ólafsson E
Dept. of Neurology, Landspítali University Hospital Hringbraut, Reykjavík,
Iceland
Abstract not received.
L23 - Risk factors for epilepsy
Hauser A
Dept. of Neurology, Columbia University, New York, USA
Abstract not received.
L24 - Living with eating difficulties after stroke. Nursing
assessment and interventions.
Jacobsson C
Department of Nursing, Umeá University, Sweden
The need to eat and drink is something we all have in common and
this makes food an important element in our lives. Food is con-
sumed not only for the nourishment of the body, but it also
nourishes the heart, mind and soul. Food and food habits are
integral parts of the culture and an aspect of existence associated
with for instance lifestyles. Eating special kinds of food and
drinking special kinds of beverages reflect social and cultural
identities and are intimately related to concepts of self and identity.
Cultural food practices have symbolic meanings that people may
use to express themselves and communicate. In general, food and
eating are symbols of interpersonal acceptance, friendliness,
sociability and communion. The meal is a time to unite in fellowship
and create a sense of belonging and it is intimately connected with
emotions.
Cultural rules and learnt habits are important for our experience
of meaning in eating. When eating with other people, we are
required to follow cultural rules about how to behave and to show
table manners. Food can be treated as a code, meaning that the
messages it encodes will be found in the social relations which are
expressed in the social structure. The relationship between cultural
pattern and nutrition is central to an understanding of human life.
In nursing care, it is therefore important to pay more attention to
cultural values and nutrition in recovery from illness as well as the
promotion of wellbeing.
Literature about living with stroke indicates that recovery is
closely related to activities that matter to the patients and that the
patients’ life situations are influenced primarily by their own way of
dealing with their disabilities. The bodily breakdown may lead to
identity confusion, the feeling of unreality and the awareness of a
changed role in life. The bodily changes may result in both physical
and psychological trauma, which could be best described as
personal catastrophes.
Eating difficulty is described as related to chewing, swallowing,
loss of lip control, drooling, and leakage of food from the mouth
and is of special interest in nursing care. This may have serious
physical as well as social consequences and is reported to be stress-
ful and to result in anxiety, shame, loneliness, isolation and lack of
appetite. Research findings show that these eating difficulties cause
inadequate food intake, aspiration and malnutrition. Malnutrition
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