Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036572 (seizures)
 80,221 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We conducted a cross-sectional epidemiological study to assess the prevalence and patterns of epilepsy in a small rural village of Guatemala (population 2,111); 1,882 subjects (97.3%) were surveyed. By adminIstering the World Health Organization (WHO) standard questionnaire and performing neurological examinations, we detected 16 cases of epilepsy. The crude prevalence rate for this community was 8.5 in 1,000 general population for this form. The most common type of seizure was generalized tonic-clonic seizures (GTCS, 50%), followed by complex partial seizures (CPS, 37.5%), simple partial seizures (SPS, 6.2%) and generalized atonic seizures (6.2%). The age-specific prevalence ratio was highest among the group aged 20-29 years, although the difference between that group and the other age groups was not statistically signifICant (z<2, P>0.05). Fourteen persons (87.5%) had sought medical care for their seizures at least once in their lifetime, 5 (31.25%) were receiving an antiepileptic drug (AED), and 9 (56.25%) had previously received treatment and 2 (12.5%) had never been treated for their illness. Phenobarbital was the most common AED prescribed; 7 persons had positive family history of epilepsy, 5 reported a history of significant head trauma, 4 had history of central nervous system disease, and 1 had a history of chronic alcohol intake.
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PMID:Prevalence of epilepsy in a rural community of Guatemala. 860 43

Epilepsy is the most frequent additional handicap in mentally retarded persons. Brain injury and mental retardation may predispose to side effects of antiepileptic drugs (AEDs) on the central nervous system. 63 institutionalized mentally retarded patients were treated for epilepsy in the 1980s. AED treatment was carefully monitored, aiming at the lowest effective dose and an optimal balance between seizure control and adverse effects. In 15 patients, AEDs could be withdrawn. Drugs with less cognitive side effects, such as carbamazepine and valproate, were preferred to longer established drugs, such as phenobarbital and phenytoin. A pronounced decrease in the frequency of seizures was achieved during the study. Based on the calculated Defined Daily Doses, the prescription of AEDs was reduced by 18%. Phenobarbital constituted 39% of the AED consumption at the beginning and 7% at the end of the study. The corresponding figures for phenytoin were 20 and 16%. The fraction of carbamazepine increased from 31 to 44% and that of valproate from 6 to 32%. Less sedative side effects were reported. Several factors other than AEDs may have modified control of seizure in this long term study. These issues are discussed. After the reform of the system of care for the mentally retarded in Norway, it is a challenge to the health authorities to provide an adequate comprehensive epilepsy service to this group of patients.
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PMID:[Treatment with antiepileptics of mentally retarded patients. Experiences from the 1980s a challenge in the 1990s]. 863 70

Phenobarbital, diazepam, lorazepam, and phenytoin are all currently used for the treatment of acute seizures, including status epilepticus. None of these drugs is considered ideal. Fosphenytoin is a new phenytoin prodrug that fulfills many of the properties of an ideal anticonvulsant drug. The safety, tolerance, and pharmacokinetics of intramuscularly administered fosphenytoin have been evaluated in three clinical trials involving patients requiring loading or maintenance doses of phenytoin. These investigations demonstrated that fosphenytoin is rapidly and completely absorbed after injection into muscle and is quickly converted to produce therapeutic phenytoin plasma concentrations within 30 min of administration. Plasma concentrations of phenytoin achieved with i.m. fosphenytoin exceeded those associated with an equimolar dose of oral phenytoin. i.m. fosphenytoin was well tolerated both locally and systemically. Only mild and transient reactions occurred at the injection site. The most common systemic adverse events reported--somnolence, nystagmus, dizziness, and ataxia--are side effects commonly seen with phenytoin and tended to be mild. Preexisting seizure disorders remained stable. Combination treatment with i.v. diazepam or lorazepam to attain rapid seizure control and i.m. fosphenytoin to maintain the anticonvulsant effect theoretically offers many advantages for control of acute seizures and should be studied.
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PMID:Intramuscular use of fosphenytoin: an overview. 864 11

A large number of drugs can be given parenterally for the control of acute seizures, although many of these compounds are associated with serious adverse effects. Phenobarbital, the first antiepileptic drug (AED), has long been available in an injectable formulation. The sodium salt of phenobarbital is water soluble, and its parenteral formulation can be given for maintenance therapy or treatment of acute seizures. The introduction of phenytoin in 1938, and its subsequent parenteral formulation, represented a significant advance in AED therapy owing to its relative absence of sedation. However, the risk of adverse effects necessitates that the rate of phenytoin administration usually be limited to 50 mg/min. I.v. valproate has been used extensively but has not been approved for use in the United States, and its value for treating acute seizures is unclear. Several benzodiazepines have been used as adjunctive drugs for the treatment of epilepsy; given parenterally, they provide rapid CNS entry and prompt control of seizures, but their effect is short lived. Agents that have more hypnotic anesthetic properties are often used when the benzodiazepines or phenytoin alone or in combination fails.
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PMID:Parenteral antiepileptic/anticonvulsant drugs. 864 13

A totally automated analysis of felbamate was developed by using a robotized PrepStation for extraction, followed by automated liquid chromatographic (LC) analysis and data reduction. This is one of the newer direct-sample analysis approaches by LC. Felbamate was a previously approved antiepileptic agent used to treat partial seizures with and without generalization and to treat Lennox-Gastaut syndrome in pediatric patients. However, due to the reported incidences of aplastic anemia, its clinical application was recently restricted to the treatment of the latter syndrome. The automated assay using Bench Supervisor, PrepStation, and LC, based on a previously developed manual method, used 200 microliters of serum standards, quality control, or patients' plasma. These were mixed with 600 microliters of internal standard (IS) W509 dissolved in acetonitrile for protein precipitation. After axial centrifugation and standing, aliquots of the clear supernatant were transferred and washed with hexane. Aliquots of the supernatant were transferred and injected into a high-performance liquid chromatograph (HPLC). HPLC parameters included an mu Bondapak C-18 column, phosphate/acetonitrile (8:2) as mobile phase, and detection at 214 nm. Retention times were 2.9 and 4.2 min for felbamate and IS, respectively. Calibration was linear for concentrations from 10 to 200 mg/L with r > 0.994. Precision studies showed coefficients of variation ranging from 2.7% to 8.8%. Correlation with the manual method showed that r = 0.934, slope = 1.048, intercept = -2.642, and n = 21. Phenobarbital coeluted with the IS. This study demonstrated the feasibility of using a robotized, automated method for monitoring felbamate, readily extended to monitoring other antiepileptic drugs with minimal modification.
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PMID:Totally automated analysis by robotized PrepStation and liquid chromatography: direct-sample analysis of felbamate. 888 22

When perfused with a medium containing no added Mg2+, rodent thalamocortical brain slices generate spontaneous generalized thalamocortical discharges of several types. Two of these discharges, termed simple and complex thalamocortical burst complexes (sTBCs and cTBCs), are physiologically and pharmacologically similar to the spike-wave discharges of generalized absence epilepsy and to the discharges underlying generalized tonic-clonic seizures, respectively. In a further characterization of the pharmacology of generalized thalamocortical discharges recorded in rodent thalamocortical slices, the actions of anticonvulsants effective in control of partial and generalized tonic-clonic seizures, but not generalized absence seizures, were studied on these rhythms. The effects of phenytoin, carbamazepine, and phenobarbital were tested against sTBCs and cTBCs recorded in vitro in rodent thalamocortical slices. When applied in clinically relevant concentrations, phenytoin and carbamazepine were very effective in reducing or blocking cTBCs. These drugs were much less effective in controlling sTBCs. Phenobarbital was effective in controlling both sTBCs and cTBCs, but the level of block was greater for cTBCs. Therefore, it appears that sTBCs and cTBCs are quite distinct in their relative sensitivity to anticonvulsant drugs, and this differential sensitivity parallels the relative effectiveness of these drugs in controlling generalized absence and generalized tonic-clonic seizures.
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PMID:Anticonvulsant drug effects on spontaneous thalamocortical rhythms in vitro: phenytoin, carbamazepine, and phenobarbital. 892 3

The clinical research results on idiopathic epilepsy (IE) in the dog performed at the Institute of Animal Neurology in Berne between the years 88-95 are presented. Special emphasis was placed on the genetic and electroencephalographic aspects obtained from large, uniform dog populations. We showed that IE affects all dogs of different ages. Although the clinical manifestation of seizure activity included different seizure types, a breed-specific seizure expression was found in the Retriever dog. Furthermore the use of interictal electroencephalography in the confirmation of IE was demonstrated. The results of a long-term treatment study with Phenobarbital in 46 Labrador Retrievers with IE are reported. In addition, the genetical and epidemiological aspects of the disease in each a large Golden and Labrador Retriever dog population were analysed.
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PMID:[Idiopathic epilepsy in the dog]. 902 9

Hyperthermic seizures were elicited in groups of freely ambulant rats with jets of hot water of 55 degrees C on the head for about 10 mins. Bipolar depth EEG from the hippocampus and the behavioural seizures following the stimulation were recorded. The rectal temperature (threshold) for seizure initiation was 41.5 degrees C. The seizures were predominantly clonic jerks accompanied by large spikes and slow waves lasting for 30-60s. After 3 stimulations (once a day), Phenobarbitone (Pb) 0.02 mg/g daily, Diphenylhydantoin (DPH) 0.001 mg/g, 0.005 mg/g and 0.04 mg/g. daily and Nifedipine (Nif) 0.005 mg/g twice daily were administered intraperitoneally in different rats. During the 10-days injection trials, Pb completely suppressed seizures whereas DPH and Nif did not have any effect. One of the rats with DPH showed increased epileptic activity. After a 10 day 'washout' period' Pb and DPH were interchanged and again the rats were tested for seizures on 10 days. On changing over to Pb from DPH there was complete suppression of seizures and electrical seizure discharges. Whereas those rats which earlier had no seizure activity with Pb started showing the same on changing over to DPH.
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PMID:Effect of antiepileptic drugs and calcium channel blocker on hyperthermic seizures in rats: animal model for hot water epilepsy. 905 98

The major established drugs used in the management of epilepsy are carbamazepine, valproic acid, phenytoin, phenobarbital, primidone, ethosuximide and benzodiazepine drugs. Carbamazepine and phenytoin are used mainly in the treatment of partial seizures and primarily or secondarily generalized tonic-clonic seizures. Valproic acid is effective against all types of seizures, but it is used most extensively in the management of generalized epilepsies. Ethosuximide is effective against absence seizures. Phenobarbital and primidone are effective against all types of seizures (except for absences) although they are less commonly used because of their sedative properties and adverse effects on cognition. Benzodiazepines are most valuable in the treatment of status epilepticus, but their long-term use is often associated with undesirable sedation and development of tolerance to their antiepileptic effect. Irrespective of the drug used, optimal clinical management requires individualization of dosage and dosing schedules based on careful evaluation of clinical response and sound knowledge of the pharmacokinetics and interaction potential of the individual compounds. Monitoring serum drug concentrations may provide a useful guide to dosage adjustments, particularly in the case of phenytoin, which shows dose-dependent kinetics within the therapeutic dosage range.
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PMID:Established antiepileptic drugs. 906 76

A 2.5-year-old child receiving phenobarbital for a history of seizures while on continuous cycling peritoneal dialysis (CCPD) had persistent subtherapeutic serum levels despite progressive dosage increases. Phenobarbital concentration was measured in the peritoneal dialysate effluent and peritoneal clearance was calculated. Thirty-five percent of the total phenobarbital daily dose was being removed through 24-hour CCPD. Our findings were consistent with previous reports of 40% and 50% phenobarbital removal during continuous ambulatory peritoneal dialysis and acute peritoneal dialysis, respectively. In addition, phenobarbital clearance was greater during the period when more exchanges were done compared with the period when patient went through one cycle with a longer dwell time. Based on these preliminary data, it seems that larger dosages of phenobarbital are necessary in patients undergoing continuous peritoneal dialysis, and that the amount removed can differ significantly depending on the number of cycles.
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PMID:Removal of phenobarbital during continuous cycling peritoneal dialysis in a child. 925 May 68


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