Applying the mecholyl (Funkenstein) test, which is known as being usable for the prediction of prognosis or responsiveness to therapies of psychoses, to 47 patients with epileptic seizures and to 10 normal volunteers, the present author has studied the results from several clinical view points.
From the principal component analysis of 10 parameters of the mecholyl test, it has become evident that there are four compontents; the 1st component related to the responsivenese of a subject, the 2nd one related to the recuperatability of blood pressure, the 3rd one related to the repulsiveness and stableness of blood pressure and the 4th one related to the systolic blood pressure, in the patients. In the normal volunteers, the systolic pressure contributes to the 2nd component and the 4th component is considered as the residuals, while it seems to be an independent component but contributes also to the 1st component. Since Gellhorn index exclusively contributes to the 1st component, while Suwa index fairly much contributes to the 2nd component, the latter can reflect more parameters. Few parameters showed a sex and age-related difference but statistically not significant as a whole.
From the study of typological classifications according to Suwa, Gellhorn and Okinaka, there were many normotensive and hypotensive reaction types. Above all, Suwa's classification has been found to be the most discriminative against abnormal responses, such as hyper and hyporeactors.
From the study on clically classified patients' groups with discriminat function analysis using the 10 parameters, the discriminations between yonng patients and aged patients, between those who received a therapy within one year from the onset of epilepsy and the others, at a correctiveness of 100%.
In the study on EEG abnormalities, the lower the degree of abnormalty the more the sympathetic hyperreactor, while the higher the degree of abnormality the more the parasympathetic hyperreactor. In particular, there are few N types and many P types in patients with spike or sharp wave foci. The incidence of S type occupies a certain fixed proportion regardress of the EEG abnormalities.
As to clinical seizure types of the patients, there was no N type reaction in the cases of psychomotor and other partial seizures only. It was possible to discriminate at a correctiveness more than 80% between generalized motor convulsion and psychomotor seizure. It may suggest that there are a difference of autonomic nervous functioning between patiants of centrencephalic and those of focal cortical seizures.
There were relatively ma ny sympathetic hyperreactors and few hyporeactors in patients who were not clinically improved by the medication. Therefore, a hypotensive reaction can be a favorable sign and hypertensive one may be unfavorable sign as far as prognosis is concerned.
Discriminant analysis is quite effective for clinical improvement scores and its corr ectiveness exceeds 80% in generalized motor convulsion and reaches to 100% in psychomotor seizure. The reason, why correctiveness of discrimination in the epileptic patients as a whole was low, seems to be due to the differences of important parameter between different seizure types.
Consequently, it is clear that each mecholyl parameter contains various informations, including information about prognosis of the epilepsy. For the purpose of extracting the necessary information, the discriminant analysis is more effective than typological classifications such as Suwa's and Gellgorn's. The difference can be considered as having been resulted from that the Suwa's and Gellhorn's indeces use only four parameters but the discrminant function uses all the seven paraiscriirs.
