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)

Acute effects of several antiepileptic drugs on low-frequency amygdaloid-kindled seizures were assessed. The number of stimulating pulses required for the provocation of epileptic afterdischarge (pulse-number threshold, PNT) was used as an indicator for the seizure-generating threshold. The duration of epileptic afterdischarge (AD duration) was used as an indicator for the severity of the induced seizures. Phenytoin (PHT) and carbamazepine (CBZ) reduced AD duration more than did elevating PNT. Conversely, phenobarbital (PB) and diazepam (DZP) elevated PNT more than did reducing AD duration. Weak effects on the two indicators, valproic acid (VPA) and ethosuximide (ESM), were observed. Low-frequency kindling may be a useful experimental model of epilepsy in drug-assessments.
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PMID:Acute effect of anticonvulsants on amygdaloid kindled seizures induced with low-frequency stimulations. 310 73

Medical records for 572 patients in two extended care facilities were reviewed to study seizure disorders and antiepileptic drug use. Seventy patients (12.2 percent) were receiving antiepileptic drugs. Of this group, 43 patients (61.4 percent) had a diagnosis of epilepsy or documented seizures, 2 were being treated for neuralgia, and 25 (35.7 percent) had no reason given for antiepileptic use. The most common cause was cerebrovascular accident (38.9 percent), and no associated etiology was found in 29.2 percent. Phenytoin was the most commonly used agent. Thirty-two (45.7 percent) were taking two or more antiepileptic drugs. Thirteen patients had had no serum concentration monitoring in the last year. Thirty-seven patients (52.9 percent) had had at least one serum concentration outside of the therapeutic range.
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PMID:Use of antiepileptic drugs in the elderly population. 310 51

Factors which may contribute to cognitive impairments in epilepsy are briefly reviewed. In particular, memory deficits, attentional problems, psychomotor slowing and reading and writing difficulties are highlighted, and the impact of the seizures, brain damage, and anticonvulsant drugs on cognitive function noted. With regards to the latter, the impairments associated with Phenytoin and Phenobarbitone are contrasted with the minimal effects of newer anticonvulsant drugs such as Sodium Valproate and Carbamazepine.
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PMID:[Cognitive effects of antiepileptic drugs]. 311 40

A young woman with epilepsy had tonic-clonic seizures during antineoplastic therapy with adriamycin and cisplatin. During two courses of cytostatic drug administration peak and trough plasma levels of phenytoin, carbamazepine, and valproate sodium were measured. Lower plasma levels of carbamazepine and valproate sodium were observed after 2 days of antineoplastic therapy. Normal plasma levels of these drugs were found 2 to 3 days after the last cisplatin dose. Impaired absorption or accelerated elimination might explain these results. Phenytoin levels were reduced to 37% of the original values, although the drug was given intravenously. Changed Michaelis-Menten parameters suggest that cisplatin increases the metabolic rate of phenytoin. Another explanation for the decreased drug levels might be an increased volume of distribution. Calculation of this volume from peak and trough levels showed an increase of the volume of distribution during and after chemotherapy.
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PMID:An interaction between cytostatic and anticonvulsant drugs. 312 15

A 5 years old girl with status epilepticus refractory to treatment with Diphenylhydantoin at a dose of 30 mg/kg/day and Thiopental in continuous IV perfusion at a dose of 4 mg/kg/h is presented. Control of status was achieved by continuous IV perfusion of Chlormethiazole at a dose of 10 mg/kg/h which also caused respiratory depression. Seizure activity reappeared after IV perfusion of Chlormethiazole was retired, and could be controlled only with Sodium Valproate. Mechanisms of action of Chlormethiazole and its effectiveness in treatment of refractory status epilepticus are revised.
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PMID:[Treatment of refractory status convulsivus with chlormethiazole]. 314 89

The influence of antiepileptic drugs on the wet dog shakes (WDS) induced by intracerebroventricular injections of carbachol (30 micrograms icv) was investigated in rats. Diphenylhydantoin (DPH, 8 and 4 mg/kg), diazepam (0.4, 0.2 and 0.1 mg/kg), phenobarbital (12.5, 6.25 and 3.12 mg/kg), sodium valproate (Depakine, 200, 100 and 50 mg/kg) and trimethadione (200, 100 and 50 mg/kg) given ip inhibited the WDS in a dose-dependent manner. These drugs at the same doses did not change the intensity of shaking behavior induced by lithium chloride or 5-hydroxytryptamine. As the antiepileptic drugs tested in these experiments did not have anticholinergic activity and at used doses were not able to prevent electrical convulsions or pentetrazol-induced seizures, it appears that carbachol-induced WDS could be connected with convulsive activity and could be the initial stage of seizures.
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PMID:Inhibition by antiepileptics of carbachol but not lithium- or 5-methoxytryptamine-induced wet dog shakes in rats. 314 10

Phenytoin-induced gingival overgrowth (PIGO) is a recognized side effect in many cerebral palsy patients using diphenylhydantoin (Dph) for the control of seizures. Severe degrees of gingival overgrowth can affect the patient's dentition by: 1) interference with normal masticatory function to the point of documented weight loss, 2) producing an ectopically erupting dentition to the point of poor occlusal development, and 3) producing an unattractive appearance, in those patients who appreciate their esthetics, to the point of lessened self-concept. The purpose of this investigation was to evaluate the management of a group of 142 patients, with various cerebral palsy diagnoses, as to the use of diphenylhydantoin for the control of seizures. If diphenylhydantoin was used, the presence, degree, and surgical management of PIGO was documented. Additionally, if surgical treatment was employed for removal of hyperplastic gingiva, the indications for outpatient treatment (no use of general anesthetic) or inpatient (hospital admission and use of a general anesthetic) were identified. A discussion of major indications of surgery and postoperative complications of all surgical procedures is provided.
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PMID:Incidence and indications for surgical management of phenytoin-induced gingival overgrowth in a cerebral palsy population. 316 72

We analyzed a retrospective series of 195 patients with documented intracerebral metastases (ICM) to assess the frequency of late seizure development and the impact of prophylactic anticonvulsants. Eighteen percent of the patients presented with seizures. Of the remaining patients, 40% received prophylactic anticonvulsants (diphenylhydantoin [DPH] in greater than 90%). Ten percent developed late seizures at an interval from the diagnosis of ICM ranging from 1 to 59 weeks. No patient with a posterior fossa lesion developed seizure; conversely, patients with evidence on initial examination of cerebral hemispheric dysfunction had a higher incidence of late seizure development. The incidence of seizure was virtually identical in patients who received DPH compared with those in whom it was withheld, although two thirds of patients who developed seizure while on DPH had a serum anticonvulsant level that was subtherapeutic. Based on the above findings and until prospective data become available, we recommend that anticonvulsants be withheld in newly-diagnosed patients with ICM until the first seizure.
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PMID:Should prophylactic anticonvulsants be administered to patients with newly-diagnosed cerebral metastases? A retrospective analysis. 317 27

Secondarily generalized convulsive status epilepticus was induced by intraperitoneal (i.p.) injection of D,L-homocysteine thiolactone to rats with actively epileptogenic cobalt lesions in motor cortex. This induced focal motor seizures which secondarily generalized. Control animals not treated with antiepileptic drugs had a mean of 18.3 generalized convulsions over a mean period of 103.8 min. Electrographic patterns seen during status epilepticus are described and are very similar to those seen during human status epilepticus. Phenytoin, phenobarbital, diazepam and lorazepam were all effective in arresting the generalized seizures when given i.p. after the second such seizure. Efficacy was serum drug concentration dependent. Concentrations effective in arrest of generalized seizures in this model are similar to those reported to be effective in the treatment of human status epilepticus. Diazepam ED50s for control of generalized tonic-clonic seizures and for arrest of all seizure activity were determined.
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PMID:Experimental secondarily generalized convulsive status epilepticus induced by D,L-homocysteine thiolactone. 319 90

Phenytoin is used extensively in the treatment of various forms of epilepsy, and remains the drug of choice in partial and generalized tonic-clonic seizures. Because it demonstrates saturable, Michaelis-Menten pharmacokinetics, dosing of phenytoin within the therapeutic range can be very challenging, especially so in obese patients. We present case reports of two obese patients each requiring very large doses of phenytoin sodium (1000 mg/d) to sustain therapeutic serum concentrations and seizure control. There are very few reports in the literature regarding phenytoin pharmacokinetic changes in the obese. We can only theorize possible changes in these parameters. Further investigation in the form of controlled research trials need to be performed before final dosage recommendations can be given.
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PMID:Phenytoin dosing in obese patients: two case reports. 321 15


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