Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0149958 (complex partial seizures)
 2,563 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Studies on discontinuing medication in epileptic patients who have been maintaining favorable progress and who have remained free of epileptic seizures for a long period have only been reported in comparatively small numbers and the conditions necessary to evaluate such patients as well as the methods used to enable the discontinuation of antiepileptic drug treatment to be decided have not yet been established. With the recent rapid advances in the treatment of epilepsy, any long-term treatment should be designed to include the possibility that the discontinuation of medication may be possible and this possibility should be understood from the start of treatment planning. In this study, the author has attempted to gradually or completely withdraw medication from epileptic patients who maintain favorable progress, using specific criteria and methods established by the author. The criteria used were: (1) patients should have been free of epileptic seizures for three years or more, (2) no epileptic discharge had appeared on the EEG within the previous 2-3 years (recorded during sleep as well as when awake) and (3) the patient's consent should have been obtained regarding the gradual or complete withdrawal of medication. The subjects were 40 patients (23 males and 17 females) with a mean age of 32.2 years. Seizures were primary generalized tonic/clonic in type (P-GTC) in 4 patients, complex partial seizures (CPS) in 22 and generalized sleep convulsions (GC(S)) in 14. In this study, patients with absence epilepsy taking a favorable course and those with benign childhood epilepsy showing epileptic discharges in the temporal to central region (rolandic seizure) or in the occipital region were not included. If epileptic discharges appeared on EEG recordings in the course of this study during the process of gradual drug withdrawal aiming toward complete drug withdrawal, attempts to completely withdraw medication were suspended. In this study, therefore, the period before the process in which the cessation of attempts at complete withdrawal of medication was involved due to the EEG showing epileptic discharges was taken as 'the former period' and the period in which the above process was involved was taken as 'the latter period'.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Discontinuation of antiepileptic drug treatment in controlled seizure patients]. 240 39

We investigated the conversion of mephenytoin to nirvanol in five patients with uncontrolled complex partial seizures. After a 50-mg single oral dose, mean peak mephenytoin level was 0.48 microgram/ml and nirvanol 0.37 microgram/ml. After 400 mg, peak mephenytoin level was 3.9 micrograms/ml and nirvanol 2.5 micrograms/ml. On 400 mg daily, mephenytoin reached a mean steady-state level of 1.5 micrograms/ml. Nirvanol mean steady-state level was 18 micrograms/ml. Mean plasma half-life was 17 hours for mephenytoin and 114 hours for nirvanol. Two patients had reduced seizures during mephenytoin therapy and one a transient increase during drug withdrawal. No toxicity was seen, but mephenytoin was not more effective than phenytoin.
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PMID:Disposition of mephenytoin and its metabolite, nirvanol, in epileptic patients. 643 15

After reaching an apparent steady state, plasma phenytoin (PHT) levels may then undergo inexplicable changes, a phenomenon called " pseudosteady state". We evaluated 13 pseudosteady -state periods in 10 inpatients with complex partial seizures. Eleven of the periods occurred after a change in PHT dosage and two after drug withdrawal. The pseudosteady -state period began 2 to 12 days (means = 5.7 days) after dosage change and lasted 5 to 10 days (means = 6.3 days), during which plasma PHT levels were stable (+/- 5%). Plasma PHT levels thereafter fluctuated spontaneously by greater than 25% for 5 to 22 days (means = 10.8 days). A final steady-state level was reached 13 to 31 days (means = 21.4 days) after the first dosage change. Falling plasma PHT levels increased seizure frequency in two patients, and a level of 52 micrograms/ml led to medication toxicity in another.
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PMID:Phenytoin: the pseudosteady-state phenomenon. 673 35

A developmentally normal 4-year-old white female who presented with pain in the right hand as the only manifestation of epilepsy is reported. Two years later, she developed complex partial seizures following right-hand pain. Computed tomography and magnetic resonance imaging were unremarkable. Prolonged ambulatory electroencephalography (EEG) as well as video-EEGs with ictal pain episodes failed to reveal abnormalities. Only a full night video-EEG performed after antiepileptic drug withdrawal demonstrated 2 right-hand pain episodes followed by a complex partial seizure with ictal epileptiform activity on the scalp EEG in the left parasagittal area, rapidly generalized and interictal discharges in the C3-P3 area. This patient had a very unusual presentation of epilepsy.
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PMID:Paroxysmal pain as sole manifestation of seizures. 829 19

We evaluated the prognostic value of the EEG in 120 seizure-free epileptic patients (49 with complex partial seizures with or without episodic secondarily generalization [CPS], 20 with simple partial seizures with or without episodic secondarily generalization [SPS], 51 with only secondarily generalized seizures [PSG] during and after antiepileptic drug withdrawal. All patients had EEG examination before; during; and 3, 12, 24, and 36 months after drug withdrawal. Relapse rates were 45% in CPS, 100% in SPS, and 65% in PSG. Before reduction, 36 patients had epileptiform EEG and 69% relapsed; in the group with normal EEG, 60% relapsed. EEG worsened in 36 patients, 83% relapsed, whereas only 54% of patients with unchanged EEG relapsed. EEG during but not at the start of drug withdrawal has a prognostic value in partial epilepsy.
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PMID:The prognostic value of the electroencephalogram in antiepileptic drug withdrawal in partial epilepsies. 959 37