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Query: UMLS:C0036572 (seizures)
 80,221 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The incidence of carbamazepine-associated behavioral side effects in 65 individuals with mental retardation and additional seizure and/or psychiatric or behavioral disorders was evaluated. We identified 6 patients (9.2%) who experienced medication side effects, ranging from irritability to mania. Four of the 20 patients (20%) who received carbamazepine purely for treatment of a behavioral or psychiatric disorder experienced medication side effects, whereas none of the 21 patients treated for an isolated seizure disorder experienced similar effects. This difference was statistically significant, p less than .05. The incidence of behavioral side effects of medication was not associated with age, sex, or serum carbamazepine level. The chemical structure and mechanism of carbamazepine use in various disease processes were discussed.
Am J Ment Retard 1992 Mar
PMID:Adverse behavioral effects in individuals with mental retardation and mood disorders treated with carbamazepine. 156 12

In order to compare the multiple-dose bioavailability of carbamazepine (CBZ) from 2 slow-release preparations, Neurotol slow and Tegretol Retard, a single-blind, randomized, cross-over study was carried out. 21 adult patients with epilepsy were enrolled in the study. At the end of both 2-week treatment periods, a blood sample series was drawn after the administration of the morning CBZ dose. The serum concentrations of CBZ, CBZ-10,11-epoxide (CBZE) and 10,11-dihydro-10,11-trans-dihydroxy-CBZ (CBZD) were measured using HPLC. The mean bioavailability of CBZ from Neurotol slow was 11% (P = 0.002) higher than from Tegretol Retard. Owing to the better bioavailability, the peak (Cmax), lowest (Cmin) and mean (Css) concentrations of CBZ were also significantly higher during Neurotol slow treatment. Fluctuation of serum CBZ concentrations (Cmax-Cmin/Css, ADCss/AUC0-12h) did not differ significantly between the 2 treatments; neither did tmax. Similar results were obtained with CBZE and CBZD. There were more epileptic seizures on Tegretol Retard than on Neurotol slow, but the difference was not statistically significant. We conclude that there are significant differences in the bioavailability of CBZ from these 2 slow-release preparations.
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PMID:Comparative bioavailability of carbamazepine from two slow-release preparations. 156 39

Blood magnesium levels from a mentally retarded/developmentally disabled population with difficult to control seizure disorders were presented. The role of low blood magnesium with regard to seizure activity and its causes was discussed.
Ment Retard 1991 Dec
PMID:Blood magnesium levels in a mentally retarded/developmentally disabled seizure population. 177 78

Coulter (1991) concluded that a "poor study design" (p. 81) was used and my hypothesis was unproven. My article was not an experimental study in the sense of presenting experimental data intended to confirm or deny my hypothesis. Rather, it: 1. Described remarkable similarity between movements in patients with mental retardation during self-injury episodes and reports in the literature of involuntary movements during confirmed frontal lobe seizures; 2. Pointed out that the movements by some patients with mental retardation were so frequent and/or forceful that self-injury resulted; 3. Presented the hypothesis that the movements by patients with mental retardation may, in some cases, be involuntary and due to undiagnosed frontal lobe seizures; and 4. Suggested that if this hypothesis were correct, then one ought to consider what sort of treatment approaches might reduce the incidence/severity of frontal lobe seizure episodes. I agree that a well-designed experimental study to test my hypothesis would be very desirable. The preceding literature review has shown how difficult it would be using present methods to do a definitive study that rigorously confirms or rejects my hypothesis. Other approaches might be considered for testing my hypothesis with persons who are unable to give informed consent. One approach using rigorous observable criteria was suggested. In the interim, it seemed worthwhile to present my hypothesis to mental retardation professionals with the hope that others would consider this possibility and its implications for diagnosis and treatment, and the hope that some patients might benefit sooner rather than later. I appreciate Coulter's (1991) comments because they provided an opportunity to clarify potential misunderstandings. It is possible that other readers have had similar concerns, and I trust that this is the appropriate forum for addressing such matters.
Am J Ment Retard 1991 Jul
PMID:The self-injury hypothesis: addressing a neurologist's concerns. 190 83

1. Twenty-one epileptic patients completed a double-blind, double-dummy, random order, crossover comparison of conventional carbamazepine (CBZ, Tegretol, Ciba-Geigy) with a new controlled-release formulation (CBZ-CR, Tegretol Retard). All participants were stabilised on maximally tolerated doses of CBZ as monotherapy (one twice daily, twelve three times daily, eight four times daily). Each preparation was taken with a matched placebo of the other for 4 weeks. 2. Peak serum CBZ concentrations (mean +/- s.e. mean) were lower (CBZ 11.4 +/- 0.4 mg l-1; CBZ-CR 10.4 +/- 0.5 mg l-1; P less than 0.01) and times to peak longer (CBZ 3.6 +/- 0.5 h, CBZ-CR 5.2 +/- 0.7 h, P less than 0.01) during CBZ-CR treatment. Mean CBZ concentrations, however, were also slightly reduced with the new formulation (CBZ 9.9 +/- 0.3 mg l-1; CBZ-CR 9.1 +/- 0.5 mg l-1, P less than 0.05) and this was associated with greater seizure frequency (CBZ 2.8 +/- 1.2, CBZ-CR 3.8 +/- 0.9; P less than 0.05) during the CBZ-CR treatment phase. 3. Diurnal fluctuations (CBZ 41 +/- 3%, CBZ-CR 28 +/- 2%, P less than 0.01) and variations (CBZ 53 +/- 5%, CBZ-CR 33 +/- 3%; P less than 0.01) in serum CBZ concentration were substantially less with CBZ-CR and were similar to those calculated during a 6 or 8 hourly dosage interval with conventional CBZ (fluctuation 33 +/- 3%, variation 42 +/- 5%).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Monotherapy with conventional and controlled-release carbamazepine: a double-blind, double-dummy comparison in epileptic patients. 188 46

Extreme self-injury (e.g., head-banging, skin-gouging, and self-biting) among mentally retarded people has typically been very difficult to reduce or eliminate. Clinicians design behavior programs to reduce these behaviors based on various theories that presume this is volitional behavior. In this study specific limb and eye movements plus other ictal phenomena were catalogued from the neurologic literature on frontal lobe seizures. Ten patients were described who presented the clinical picture of frontal lobe seizures. Extreme self-injury in some brain-damaged persons was therefore regarded as involuntary, and need for recognition of this behavior as frontal lobe dysfunction, not a "behavior problem" under voluntary control, was noted.
Am J Ment Retard 1989 Jul
PMID:Extreme self-injury attributed to frontal lobe seizures. 190 83

The contemporary behavior analyst, to operate ethically and effectively, must be aware of many more factors affecting behavior than simple consequences. Although the literature demonstrating the effectiveness of active behavior management is impressive, a compelling argument can be made that a great number of behavior problem seen in individuals with developmental disabilities may be attributable to factors other than consequences. Our experience has been more often than not that physiological, organic, medication, or situational variables are the actual culprits in maladaptive behavior. Individuals with severe or profound retardation may respond to aversive features of their environment by displaying noncompliance, tantrums, aggression, or self-injurious behavior. These antecedents can affect their behavior just as powerfully as can the consequences of their behavior. Behavior analysts must become sensitive to these potential factors and be prepared to employ behavioral diagnostic strategies in the search for the causes of maladaptive behavior. Finally, they must be prepared to design rather unconventional passive behavior management treatment programs involving the manipulation of the antecedent environment. In the case of Carrie, from the example at the beginning of this paper, the analysis yielded the hypothesis that her face scratching was a reaction to sinus blockage caused by seasonal allergies. Her treatment involved daily dosages of antihistamines administered by our nurses and subsequent elimination of the scratching. Tom was found to be suffering from "wheelchair fatigue." When he was allowed to recline on other surfaces (e.g., bean bag chair, mat, bolster) on a regular basis, he did not attempt any form of self-injury. Melissa was found to have a severe case of Pre Menstrual Syndrome as well as seizure disorder, and was treated with the appropriate medications. Her headbanging was reduced to a few minor incidents per month. Walter's tantrums on closer inspection seemed part of a chain of behavior leading to seizure-like attacks. Preliminary evidence suggests that when he is treated with phenobarbital the tantrums and aggression disappear. And finally, Debbie was found to be very sensitive to a variety of discomforting events. She would cry, sob, and scream when she was wet, thirsty, hungry, and tired. Changing her regularly, offering her water every hour and extra snacks in the morning as well as short naps in the early afternoon eliminated the crying and sobbing. She now participates with the other clients and seems to enjoy the house activities.(ABSTRACT TRUNCATED AT 400 WORDS)
Monogr Am Assoc Ment Retard 1989
PMID:Behavioral diagnostics. 274 44

Fifty patients with developmental disabilities and past history of epilepsy but without reported seizures fo several years underwent trial reductions of an antiepileptic drug. After an 8-year follow-up there was recurrence of seizures in 26 patients. Predictors for a seizure free state off medication were: few documented seizures in lifetime, no gross neurological abnormalities, medication below therapeutic levels at time of discontinuance, and persistently normal EEGs before and after discontinuance. Successful withdrawal of medication may have resulted from early control of seizures or early treatment; lack of actual epileptic seizures but presence of "pseudoseizures"; isolated event seizures; or seizures that could have resulted from nonepileptic, self-limiting factors.
Am J Ment Retard 1989 May
PMID:Discontinuance of antiepileptic medications in patients with developmental disability and diagnosis of epilepsy. 278 18

A barbiturate (phenobarbital or primidone) was withdrawn over a period of 3 months from 25 institutionalized residents, all of whom had had three seizures or less in the past 6 months and were maintained on a nonsedating drug (phenytoin, carbamazepine, or valproic acid). Results were compared with a matched comparison group maintained on both drugs. Subjects withdrawn from primidone, but not those withdrawn from phenobarbital, had increased seizure frequency, probably due to withdrawal. After 14 months, seizure-free subjects withdrawn from barbiturates were no more likely to have had seizures than were comparison subjects. Barbiturates appear to be unnecessary and may be withdrawn.
Am J Ment Retard 1988 Nov
PMID:Withdrawal of barbiturate anticonvulsant drugs: prospective controlled study. 314 87

This was a survey of 1,012 non-institutionalized mentally retarded persons living in a medium-sized metropolitan area. The sample was drawn from special schools and two service agencies in Auckland that serve preschool and adult retarded people. These are the main organizations serving this population in Auckland, and collectively they include a large proportion of non-institutionalized retarded individuals in this city. A comprehensive summary of current medication was obtained for each subject. A variety of demographic, medical, social, and sleep data were collected and, where appropriate, information was gathered regarding time elapsed since the last seizure. Two percent of preschoolers, 3% of special school students, and 14% of adults were receiving psychotropic drugs. Anticonvulsant drugs were prescribed for 31% of preschoolers, 17% of special school cases, and 18% of the adults. A large proportion of the demographic, medical, and social/sleep variables were associated with drug prescription patterns. These factors were discussed with respect to other surveys, and possible explanations were offered to account for their relationship to pharmacotherapy.
Appl Res Ment Retard 1985
PMID:City-wide survey of drug patterns among non-institutionalized mentally retarded persons. 401 83


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