The following MEDLINE items were compiled by SilverPlatter and are presented with their generous cooperation and permission. (See SilverPlatter's Worldwide Library for bibliographic search information.)
MEDLINE EXPRESS (R) 1/96-11/96 1 of 26
TI: Evolution of Lennox-Gastaut syndrome: a long-term longitudinal study.
AU: Yagi-K
AD: National Epilepsy Center, Shizuoka Higashi Hospital, Japan.
SO: Epilepsia. 1996; 37 Suppl 3: 48-51
ISSN: 0013-9580
PY: 1996
LA: ENGLISH
CP: UNITED-STATES
AB: In 102 patients with Lennox-Gastaut syndrome (LGS) observed for an average of 16 years (range, 10-20 years), 12 of the patients worked normally, 36 worked part-time or at a sheltered workshop, and most of the remaining 54 were under home care or institutionalization. LGS evolved from West syndrome or from unspecified epilepsies, or as the primary form, mostly in childhood and rarely in adolescence or adulthood. At the worst stage, there were diverse types of generalized seizures, slow spike-and-wave EEG complexes, fast rhythms, and multiple spike-and-wave complexes. Mental subnormality progressively worsened. Characteristic symptoms of LGS continued in one third of patients, and various abortive forms of LGS were seen in the other two thirds, although LGS did not evolve into a localization-related epilepsy during the survey period. The evolution of seizure and EEG epileptic discharges suggests that LGS has a characteristic clinical course as it progresses. The persistent generalized tonic seizures of various magnitude over a long time in the vast majority of patients indicate that the brainstem rather than the cortical mantle is involved as the seat of seizure-generating mechanisms in LGS.
MESH: Adolescence-; Adult-; Age-of-Onset; Brain-Stem-physiopathology; Child-; Corpus-Callosum-surgery; Disease-Progression; Electroencephalography-; Epilepsy-physiopathology; Epilepsy-rehabilitation; Follow-Up-Studies; Infant-; Longitudinal-Studies; Mental-Retardation-diagnosis; Middle-Age; Outcome-Assessment-Health-Care; Prognosis-; Spasms,-Infantile-diagnosis
MESH: *Epilepsy-diagnosis
TG: Female; Human; Male
PT: JOURNAL-ARTICLE
AN: 96310693
UD: 9610
MEDLINE EXPRESS (R) 1/96-11/96 2 of 26
TI: Long-term prognosis of Lennox-Gastaut syndrome.
AU: Oguni-H; Hayashi-K; Osawa-M
AD: Department of Pediatrics, Tokyo Women's Medical College, Japan.
SO: Epilepsia. 1996; 37 Suppl 3: 44-7
ISSN: 0013-9580
PY: 1996
LA: ENGLISH
CP: UNITED-STATES
AB: We investigated the long-term prognosis of Lennox-Gastaut syndrome (LGS) in 72 patients followed up for > 10 years. Long-term seizure and intellectual outcomes were poor, as previously reported. The diagnosis of LGS was first made in the age range from 2 to 15 years with peak occurrence at 5 years. Progressive IQ score deterioration with age was apparent. At the last examination, 33% of patients with cryptogenic and 55% with symptomatic LGS had lost the characteristics of LGS, and their seizure disorders were classifiable as symptomatic generalized epilepsies, severe epilepsy with multiple independent spike foci, or localization-related epilepsies. Disabling drop attacks appeared in 46% of patients and tended to occur at older than 10 years. Gait deterioration was recognized in 12 patients and seemed to be due largely to progression of the epileptic encephalopathy. The gait disturbances, as well as increased frequency of violent drop attacks, were disabling in daily life and resulted in some patients being wheelchair bound.
MESH: Activities-of-Daily-Living; Age-of-Onset; Age-Factors; Child-; Child,-Preschool; Disease-Progression; Electroencephalography-; Epilepsy-physiopathology; Follow-Up-Studies; Infant-; Intelligence-Tests; Longitudinal-Studies; Mental-Retardation-diagnosis; Outcome-Assessment-Health-Care; Prognosis-; Spasms,-Infantile-diagnosis; Spasms,-Infantile-physiopathology
MESH: *Epilepsy-diagnosis
TG: Human
PT: JOURNAL-ARTICLE
AN: 96310692
UD: 9610
MEDLINE EXPRESS (R) 1/96-11/96 3 of 26
TI: [Callosotomy in the treatment of drug-resistant epilepsy]
TO: La callosotomia en el tratamiento de la epilepsia farmacorresistente.
AU: Minguez-Castellanos-A; Sanchez-Alvarez-JC; Altuzarra-A; Serrano-Castro-PJ; Hernandez-Ramos-FJ; Gomez-Camello-A; Garcia-Gomez-T
AD: Servicio de Neurologia, Hospital Virgen de las Nieves, Granada.
SO: Rev-Neurol. 1996 May; 24(129): 539-48
ISSN: 0210-0010
PY: 1996
LA: SPANISH; NON-ENGLISH
CP: SPAIN
AB: At the present time corpus callosotomy is a valuable option in the management of some patients with drug-resistant epilepsy who are not candidates for resective procedures. The records of six patients who underwent callosotomy at 'Hospital Virgen de las Nieves' (Granada, Spain) in the past four years were retrospectively analyzed. The patients all had intractable primary or secondarily generalized seizures, were severely handicapped by its frequency and nature (especially with drop attacks and multiple injuries) and were not suitable for other surgical procedure. The results of surgery (five anterior callosotomies and one subtotal section) are described after an average follow-up period of 2.5 years. Overall, four patients achieved significant improvement (at least 50% reduction in seizure frequency, severity, or both, affecting quality of life), with a marked reduction (> 75%) in two of them. There was no clinical deterioration, significant surgical complication nor relevant additional long-term neuro-psychological deficit in any case. Previous studies have been reviewed mainly to find those prognostic factors associated with a better seizure outcome or with the occurrence of complications. The best results are obtained in those patients with drop attacks (including atonic seizures) as the most frequent and disabling seizure type. According to the type of epilepsy, patients with localization-related epilepsy (especially when symptomatic of a focal brain damage) and those with the Lennox-Gastaut syndrome are the most likely to benefit from the procedure. It is suggested that, in the first place, a two-thirds anterior callosotomy should be performed particularly with atonic seizure are the most frequent seizure type. We may proceed with completion of callosal division as a second stage in those patients in whom a significant improvement has not been observed. In severely retarded patients with multiple seizure types, one-stage complete section may be performed. The procedure is relatively safe, with a low incidence of morbidity and clinically significant long-term neuro-psychological deficits. Further larger clinical studies are necessary to elucidate many aspects which are still unresolved. More uniformity would be desirable in the evaluation of patients, surgical technique, follow-up and presentation of results.
MESH: Adult-; Age-of-Onset; Brain-physiopathology; Child-; English-Abstract; Epilepsy-physiopathology; Follow-Up-Studies; Postoperative-Complications
MESH: *Anticonvulsants-therapeutic-use; *Corpus-Callosum-surgery; *Epilepsy-drug-therapy; *Epilepsy-surgery
TG: Case-Report; Female; Human; Male
PT: JOURNAL-ARTICLE
RN: 0
NM: Anticonvulsants
AN: 96243444
UD: 9610
MEDLINE EXPRESS (R) 1/96-11/96 4 of 26
TI: Epilepsy surgery in Belgium, the Flemish experience.
AU: Boon-P; Vandekerckhove-T; Calliauw-L; Achten-E; De-Reuck-J; Thiery-E; Caemaert-J; Desomer-A; Drieghe-C; Vanbelleghem-H; Vonck-K; Defreyne-L; Van-Duyse-A
AD: Department of Neurology, University Hospital, Gent, Belgium.
SO: Acta-Neurol-Belg. 1996 Mar; 96(1): 6-18
ISSN: 0300-9009
PY: 1996
LA: ENGLISH
CP: BELGIUM
AB: Between January 1992 and June 1995, 160 patients were presurgically evaluated for medically refractory epilepsy by the Epilepsy Monitoring and Surgery Team at the University Hospital of Gent. All these patients underwent a comprehensive presurgical evaluation, including extensive neurological history and examination, video-EEG monitoring of interictal EEG and habitual seizures, CT and optimum MR. In a large subgroup of these patients a comprehensive neuro-psychological examination and interictal 18FDG-PET were performed. After the non-invasive phase of the presurgical evaluation, a bilateral carotid angiography and intracarotid amytal procedure was planned in 27 patients to establish hemispheric language dominance and bilateral memory function. After proper selection, 14 patients underwent invasive video-EEG monitoring with intracranial implantation of parenchymal and/or subdural electrodes to further document the area of seizure onset. From the initial group of 160 potential surgical candidates, 40 patients (20 M, 20 F) with mean age of 31 years (range: 2 months-55 years) and mean duration of uncontrolled seizures of 16 years (range: 2 months-47 years) eventually underwent a surgical procedure. 30/40 patients were on high dose antiepileptic polytherapy. Optimum MR detected structural abnormalities, confined to a limited brain area, in 39 patients. These abnormalities were of space-occupying nature in 21 cases; an atrophic lesion was suspected in 17 patients. Structural abnormalities were most frequently located in the temporal lobe (n = 26) and the frontal lobe (n = 7). Video-EEG monitoring documented complex partial seizures in 32 patients with occasional secondary generalisation in 14. In most of these patients, seizures could be subclassified as being of temporal lobe origin based on clinical and EEG criteria. Two patients had only simple partial seizures. One patient with Sturge-Weber syndrome and a strictly unilateral angioma had hemiconvulsions. A mentally retarded patient with Lennox-Gastaut syndrome had different types of seizures. After non-invasive and invasive exploration, the area of seizure onset could be determined in all patients. Standard or modified temporal lobectomy +/- hippocampectomy were the most commonly performed procedures (n = 26). In 5 patients complete lesionectomies were performed for epileptogenic structural lesions in and outside the temporal lobe. In 2 patients only partial lesionectomies were possible; in 5 patients only biopsies could be performed. Anterior 2/3 callosotomy and hemispherectomy were each performed in one patient. Postsurgical seizure control, after average follow-up of 20 months (range: 6-40 months), was excellent in 27 patients who became seizure-free. In these patients antiepileptic therapy was tapered 2 years after surgery. An additional 4 patients continue to experience non-disabling simple partial seizures only. Patients in whom only biopsies or partial lesionectomies were performed have poor seizure control. Three patients died as a result of the intrinsic malignancy of their space-occupying lesion. Two patients who are seizure free experienced a moderate postoperative hemiparesis with subtotal recovery. Overall quality of life was substantially improved both in patients who became entirely seizure free or who experienced a very significant reduction in seizure frequency. Presurgical evaluation and epilepsy surgery are a labour intensive but rewarding therapeutic alternative for patients with medically refractory epilepsy. Besides providing therapeutic efficacy, comprehensive presurgical evaluation and epilepsy surgery allow for fruitful clinical neurological research.
MESH: Adolescence-; Adult-; Brain-Neoplasms-complications; Cerebral-Arteriovenous-Malformations-complications; Child-; Child,-Preschool; Cohort-Studies; Electroencephalography-methods; Epilepsy,-Partial-etiology; Infant-; Middle-Age; Neuropsychological-Tests; Preoperative-Care; Tomography,-Emission-Computed; Tomography,-X-Ray-Computed
MESH: *Epilepsy,-Partial-diagnosis; *Epilepsy,-Partial-surgery
TG: Female; Human; Male; Support,-Non-U.S.-Gov't
PT: JOURNAL-ARTICLE
AN: 96230863
UD: 9610
MEDLINE EXPRESS (R) 1/96-11/96 5 of 26
TI: Behavioral effects of felbamate in childhood epileptic encephalopathy (Lennox-Gastaut syndrome).
AU: Gay-PE; Mecham-GF; Coskey-JS; Sadler-T; Thompson-JA
AD: Department of Psychology, Westminster College, Salt Lake City, Utah 84106, USA.
SO: Psychol-Rep. 1995 Dec; 77(3 Pt 2): 1208-10
ISSN: 0033-2941
PY: 1995
LA: ENGLISH
CP: UNITED-STATES
AB: The behavioral effects of felbamate were assessed in 20 persons, (ages 2 to 19 years) who were participating in a compassionate plea protocol for children with Lennox-Gastaut syndrome. Parents completed a questionnaire concerning aspects of behavioral change once all medications were in a constant regimen. Significant improvements were suggested in social functioning, intellectual functioning, motor functioning, attention and concentration, alertness, initiative, variability in performance, and memory. There was a tendency for these effects to reverse when the drug was discontinued.
MESH: Adolescence-; Anticonvulsants-adverse-effects; Brain-Damage,-Chronic-psychology; Child-; Child-Behavior-Disorders-psychology; Child,-Preschool; Epilepsy-psychology; Personality-Assessment; Propanediols-adverse-effects; Social-Behavior; Syndrome-
MESH: *Anticonvulsants-therapeutic-use; *Brain-Damage,-Chronic-drug-therapy; *Child-Behavior-Disorders-drug-therapy; *Epilepsy-drug-therapy; *Propanediols-therapeutic-use
TG: Female; Human; Male
PT: JOURNAL-ARTICLE
RN: 0; 0; 25451-15-4
NM: Anticonvulsants; Propanediols; felbamate
AN: 96210501
UD: 9609
MEDLINE EXPRESS (R) 1/96-11/96 6 of 26
TI: Intravenous immune globulin in the treatment of intractable childhood epilepsy.
AU: Duse-M; Notarangelo-LD; Tiberti-S; Menegati-E; Plebani-A; Ugazio-AG
AD: Department of Pediatrics, University of Brescia, Italy.
SO: Clin-Exp-Immunol. 1996 May; 104 Suppl 1: 71-6
ISSN: 0009-9104
PY: 1996
LA: ENGLISH
CP: ENGLAND
AB: Many clinical and experimental data strongly support the role of immune mechanisms in the pathogenesis of childhood epilepsy. Following Pechadre's first observations with intramuscular immune globulin (IMIG), intravenous immune globulin (IVIG) has been employed in some forms of intractable childhood epilepsy (ICE), mainly in West syndrome (WS) and Lennox Gastaut syndrome (LGS), with good results. So far, 373 children suffering from ICE have been treated in 29 studies and 174 have responded favourably. Although these studies are heterogeneous and controls are lacking, most authors report similar responsiveness ranging from 30% to 50%. Several mechanisms have been suggested to account for the efficacy of IVIG in ICE including antiviral effect, substitutive therapy in patients with concomitant humoral immunodeficiency, idiotype-anti-idiotype interaction or a neuromodulant effect. To better define the real efficacy of IVIG in ICE in paediatric patients, a randomized, multicenter, double-blind clinical trial was started in 1993, including only patients suffering from WS and LGS. To date, only one double-blind trial had been carried out (with both adult and paediatric patients); it showed a clear trend in favour of IVIG treatment but lacked statistical significance, perhaps because of the small and heterogeneous sample. Controlled multicentre studies on well-defined populations are needed and patients with WS and LGS are probably the best candidates.
MESH: Adolescence-; Child-; Child,-Preschool; Controlled-Clinical-Trials; Double-Blind-Method; Infant-; Recurrence-
MESH: *Epilepsy-therapy; *Immunoglobulins,-Intravenous-therapeutic-use
TG: Human
PT: JOURNAL-ARTICLE; REVIEW; REVIEW,-TUTORIAL
RN: 0
NM: Immunoglobulins,-Intravenous
AN: 96215423
UD: 9608
MEDLINE EXPRESS (R) 1/96-11/96 7 of 26
TI: Exacerbation of seizures in Lennox-Gastaut syndrome by gabapentin.
AU: Vossler-DG
AD: Epilepsy Center, Swedish Medical Center, Seattle, WA 98122, USA.
SO: Neurology. 1996 Mar; 46(3): 852-3
ISSN: 0028-3878
PY: 1996
LA: ENGLISH
CP: UNITED-STATES
MESH: Acetic-Acids-therapeutic-use; Adolescence-; Anticonvulsants-adverse-effects; Anticonvulsants-therapeutic-use; Epilepsy-complications; Mental-Retardation-complications; Syndrome-
MESH: *Acetic-Acids-adverse-effects; *Epilepsy-drug-therapy; *Epilepsy-physiopathology; *Mental-Retardation
TG: Case-Report; Human; Male
PT: JOURNAL-ARTICLE
RN: 0; 0; 60142-96-3
NM: Acetic-Acids; Anticonvulsants; gabapentin
AN: 96173719
UD: 9608
SB: AIM
MEDLINE EXPRESS (R) 1/96-11/96 8 of 26
TI: Lennox-Gastaut syndrome: a new vista.
AU: Ohtahara-S; Ohtsuka-Y; Kobayashi-K
AD: Department of Child Neurology, Okayama University Medical School, Japan.
SO: Psychiatry-Clin-Neurosci. 1995 Jun; 49(3): S179-83
ISSN: 1323-1316
PY: 1995
LA: ENGLISH
CP: AUSTRALIA
AB: Lennox-Gastaut syndrome (LGS) is regarded as a model of the epileptic syndrome because of its specific clinicoelectrical manifestation. However, a close investigation reveals that its outline is somewhat vague, having the borderland around it. Precise diagnosis in an individual case is not always easy. In this paper, the diagnostic criteria of LGS are described. According to these criteria, cases with LGS were subclassified into the typical and the atypical cases, and also cases in the borderland of LGS were reviewed. On the other hand, our prospective long-term follow-up study revealed that cortical mechanisms played an important role in the pathophysiology, clinical features and refractoriness of LGS. Secondary bilateral synchrony (SBS) is supposed to be a mode of expression of cortical mechanisms of LGS. A newly developed method with coherence and phase analysis demonstrated that the pathophysiology was based on SBS in 33% of the typical LGS cases. This finding is not only crucial for the choice of rational treatment including epilepsy surgery, such as callosotomy, but also contributes to a more refined subclassification of LGS.
MESH: Child-; Drug-Resistance; Epilepsy-diagnosis; Syndrome-
MESH: *Epilepsy-physiopathology
TG: Human
PT: JOURNAL-ARTICLE; REVIEW; REVIEW,-TUTORIAL
AN: 96191099
UD: 9608
MEDLINE EXPRESS (R) 1/96-11/96 9 of 26
TI: [Clinical and electroencephalographic studies in children with hemimegalencephaly]
AU: Tagawa-T; Otani-K; Futagi-Y; Wakayama-A; Morimoto-K; Morita-Y
AD: Division of Pediatric Neurology, Osaka Medical Center and Research Institute for Maternal and Child Health.
SO: No-To-Hattatsu. 1996 Jan; 28(1): 53-9
ISSN: 0029-0831
PY: 1996
LA: JAPANESE; NON-ENGLISH
CP: JAPAN
AB: Clinical and electroencephalographic (EEG) studies were performed in two children with hemimegalencephaly. The ages of seizure onset were 44 hours after birth in one infant and 33 days of postnatal life in the other patient. In both children, infantile spasms (IS) associated with hemihypsarrhythmia, developed at 1.5 months and 4 months, respectively. The subsequent clinical courses in these children were notable for frequent, intractable seizures. The seizures consisted of either generalized or partial seizures which originated from not only the hemimegalic hemisphere but also the contralateral one. Later, the clinical and EEG findings in one child indicated the development of Lennox-Gastaut syndrome (LGS). These findings suggested that the lesions of epileptogenesis in patients with hemimegalencephaly involved not only the pathological hemisphere, but also the contralateral hemisphere and subcortical structures. A detailed neurophysiological investigation in hemimegalencephaly could help the elucidation of the pathophysiology of intractable epilepsies, such as IS or LGS.
MESH: Child-; English-Abstract; Epilepsy-etiology; Epilepsy-physiopathology; Infant-; Infant,-Newborn
MESH: *Brain-abnormalities; *Brain-Diseases-physiopathology; *Electroencephalography-
TG: Case-Report; Female; Human; Male
PT: JOURNAL-ARTICLE
AN: 96144003
UD: 9605
MEDLINE EXPRESS (R) 1/96-11/96 10 of 26
TI: [Stevens-Johnson syndrome after lamotrigine treatment]
TO: Sidrome de Stevens-Johnson tras la introduccion de lamotrigina.
AU: Campistol-J; Geli-M; Llistosella-E; Molins-J; Llobet-M
AD: Consorci Sant Gregori, Girona.
SO: Rev-Neurol. 1995 Nov-Dec; 23(124): 1236-8
ISSN: 0210-0010
PY: 1995
LA: SPANISH; NON-ENGLISH
CP: SPAIN
AB: We report a 18 years old female with Lennox-Gastaut syndrome under treatment with sodium valproate, carbamazepine and clonazepam. When seizures increased we stopped carbamazepine and introduced lamotrigine slowly. One month later the girl developed haemorrhagic erosions in mucoses and limbs with deterioration of her general state. Skin biopsy confirmed the diagnosis of erythema multiforme, the Stevens-Johnson's form. The immediate withdrawal of lamotrigine and treatment with antihystaminics and steroids was followed of a slowly favourable course with disappearance of symptomatology one month later. It's another case of Stevens-Johnson syndrome related to the introduction of lamotrigine in polytherapy.
MESH: Adolescence-; Anticonvulsants-administration-and-dosage; Anticonvulsants-therapeutic-use; Carbamazepine-administration-and-dosage; Carbamazepine-therapeutic-use; Clonazepam-administration-and-dosage; Clonazepam-therapeutic-use; Dose-Response-Relationship,-Drug; Drug-Therapy,-Combination; English-Abstract; Epidermis-pathology; Epidermis-ultrastructure; Epilepsy-drug-therapy; Necrosis-pathology; Stevens-Johnson-Syndrome-pathology; Triazines-administration-and-dosage; Triazines-therapeutic-use; Valproic-Acid-administration-and-dosage; Valproic-Acid-therapeutic-use
MESH: *Anticonvulsants-adverse-effects; *Stevens-Johnson-Syndrome-etiology; *Triazines-adverse-effects
TG: Case-Report; Female; Human
PT: JOURNAL-ARTICLE
RN: 0; 0; 1622-61-3; 298-46-4; 84057-84-1; 99-66-1
NM: Anticonvulsants; Triazines; Clonazepam; Carbamazepine; lamotrigine; Valproic-Acid
AN: 96123326
UD: 9605
MEDLINE EXPRESS (R) 1/96-11/96 11 of 26
TI: [Felbamate: perspectives for new antiepileptic treatment]
TO: Felbamato: perspectivas de un nuevo antiepileptico.
AU: Perez-Miranda-J; Aguirre-J; Parrilla-JL; Perez-Miranda-M
AD: Facultad de Medicina, Universidad de Extremadura, Badajoz.
SO: Rev-Neurol. 1995 Nov-Dec; 23(124): 1220-5
ISSN: 0210-0010
PY: 1995
LA: SPANISH; NON-ENGLISH
CP: SPAIN
AB: The present work is a review of the new anti-epileptic drug felbamate. Felbamate is a dicarbonate with antiepileptic effects in partial attacks and in Lennox-Gastaut syndrome. This new drug is especially interesting since its pharmacological action on test animals would indicate a wider anti-epileptic spectrum of activity than most other such drugs. We review the clinical pharmacology of felbamate, its development as a new antiepileptic and the new clinical control type trials carried out into epilepsy. We also give a summary of clinical trial experiments performed using felbamate in the treatment of partial refractory attack and of Lennox-Gastaut syndrome. Felbamate has turned out to be the first anti-epileptic with specific efficacy in Lennox-Gastaut syndrome. Felbamate was approved as an anti-epileptic by the United States Food And Drug Administration in July 1993 for clinical use with children suffering from Lennox-Gastaut syndrome and with adults having partial epileptic attacks. 1994 saw some cases of aplastic anaemia and liver failure associated with treatment using felbamate which called for a reevaluation of the benefit-risk factors of the drug. Its use in the European Union was restricted to Lennox-Gastaut syndrome, and rigorous liver function and haematological controls were set up in patients so treated. In the United States the FDA also allows treatment using felbamate of partial attacks not responding to any type of medicine.
MESH: Adult-; Anticonvulsants-administration-and-dosage; English-Abstract; Propanediols-adverse-effects; Propanediols-pharmacology; Receptors,-GABA-drug-effects; Syndrome-
MESH: *Anticonvulsants-therapeutic-use; *Epilepsy-drug-therapy; *Propanediols-therapeutic-use
TG: Human
PT: JOURNAL-ARTICLE; REVIEW; REVIEW,-TUTORIAL
RN: 0; 0; 0; 25451-15-4
NM: Anticonvulsants; Propanediols; Receptors,-GABA; felbamate
AN: 96123321
UD: 9605
MEDLINE EXPRESS (R) 1/96-11/96 12 of 26
TI: [Adding lamotrigine to the treatment of epilepsy which is difficult to control]
TO: Lamotrigina anadida al tratamiento en epilepsias de dificil control.
AU: Suarez-P; Vadillo-J; Suarez-C; Prieto-JM; Castillo-J; Noya-M
AD: Servicio de Neurologia, Hospital General de Galicia, Clinico Universitario, Santiago de Compostela.
SO: Rev-Neurol. 1995 Nov-Dec; 23(124): 1190-2
ISSN: 0210-0010
PY: 1995
LA: SPANISH; NON-ENGLISH
CP: SPAIN
AB: We studied the effect of adding Lamotrigine to the medication of 36 patients with refractory epilepsy (ten with Lennox-Gastaut syndrome and ten with partial epilepsy with or without secondary generalization), who were resistant to optimized treatment with other drugs and who suffered at least four attacks per month. Lamotrigine was administered progressively, the final dose varying between 25 and 400 mg per day, the average being 192.3 mg. Lamotrigine was suspended in four cases (11%) as a result of behavioural abnormalities; three further patients showed slight secondary effects; no exanthemata were observed. The average age of the 32 patients who continued with treatment was 36.25 years and the average duration of epilepsy was 22.41 years. Average follow-up time was 26.9 weeks. In the case of two patients (5.55%) the attacks disappeared during follow-up time; 25 patients (69.4%) experienced at least a 50% objective reduction in the number of attacks. In no case was treatment suspended for lack of effect. Two patients gave up other drugs and continued monotherapy using Lamotrigine. In nine of the ten Lennox-Gastaut syndrome patients the frequency of attacks went down by more than 50% and in seven such cases by more than 75%.
MESH: Adolescence-; Adult-; Aged-; Anticonvulsants-administration-and-dosage; English-Abstract; Epilepsy-complications; Middle-Age; Triazines-administration-and-dosage
MESH: *Anticonvulsants-therapeutic-use; *Epilepsy-drug-therapy; *Triazines-therapeutic-use
TG: Human; Support,-Non-U.S.-Gov't
PT: JOURNAL-ARTICLE
RN: 0; 0; 84057-84-1
NM: Anticonvulsants; Triazines; lamotrigine
AN: 96123314
UD: 9605
MEDLINE EXPRESS (R) 1/96-11/96 13 of 26
TI: [Electroencephalography and epileptology in the 20th century]
TO: Elektroenzephalographie und Epileptologie im 20. Jahrhundert.
AU: Karbowski-K
AD: Neurologische Universitatsklinik, Inselspital Bern.
SO: Schweiz-Rundsch-Med-Prax. 1995 Dec 5; 84(49): 1465-73
ISSN: 0369-8394
PY: 1995
LA: GERMAN; NON-ENGLISH
CP: SWITZERLAND
AB: In 1875, Caton was already able to detect cerebral electric currents during experimental studies in animals. In 1914, Cybulski and Jelenska-Macieszyna reported on the increase of current-intensity during a focal motor epileptic seizure. In 1929 in Jena, Berger revolutionized the study of epilepsy with his paper on the human electroencephalogram 'Uber das Elektrenkephalogramm des Menschen'. His discovery and further publications as well as later works of numerous researchers, especially F. and E. Gibbs, Lennox, Penfield and Jasper, made it possible to distinguish different forms of 'little' epileptic seizures and to separate them from nonepileptic paroxysmal disorders. New epileptic syndromes could be singled out, as e.g. the symptomatic epilepsy of childhood with variable clinical manifestations of seizures and slow spike-wave complexes in the EEG (Lennox-Gastaut syndrome) or the benign partial epilepsy of childhood with centrotemporal EEG spikes. In these fields, as well as for the epileptic seizures in newborns and babies and for the differentiation between epileptic and nonepileptic twilight states in later stages of life, the EEG remains an indispensable tool in the CT and MRI era. It also contributes largely to the diagnosis of nonepileptic cerebral illness such as herpes simplex encephalitis, subacute sclerosing panencephalitis van Bogaert and Creutzfeldt-Jakob disease. Since the introduction of phenobarbital by Hauptmann in 1912, the palet of effective drugs against epilepsy, such as phenytoin, carbamazepine, valproate and benzodiazepines used for status-epilepticus treatment, became essentially larger. The value of newer substances (vigabatrin, progabide, gabapentin, lamotrigin) can't be estimated actually.(ABSTRACT TRUNCATED AT 250 WORDS)
MESH: Anticonvulsants-therapeutic-use; Brain-surgery; Electroencephalography-history; English-Abstract; Epilepsy-classification; Epilepsy-history; Epilepsy-therapy; History-of-Medicine,-19th-Cent.; History-of-Medicine,-20th-Cent.; Nomenclature-; Portraits-; Switzerland-
MESH: *Electroencephalography-methods; *Epilepsy-physiopathology
TG: Female; Human; Male
PT: HISTORICAL-ARTICLE; JOURNAL-ARTICLE
RN: 0
NM: Anticonvulsants
AN: 96106128
UD: 9604
MEDLINE EXPRESS (R) 1/96-11/96 14 of 26
TI: Lamotrigine. An update of its pharmacology and therapeutic use in epilepsy.
AU: Fitton-A; Goa-KL
AD: Adis International Limited, Auckland, New Zealand.
SO: Drugs. 1995 Oct; 50(4): 691-713
ISSN: 0012-6667
PY: 1995
LA: ENGLISH
CP: NEW-ZEALAND
AB: Lamotrigine is an antiepileptic agent which blocks voltage-dependent sodium channels, thereby preventing excitatory neurotransmitter release. Clinical evidence indicates that lamotrigine is effective against partial and secondarily generalised tonic-clonic seizures, as well as idiopathic (primary) generalised epilepsy. As monotherapy, lamotrigine 100 to 300 mg/day has similar medium term (30 to 48 weeks) efficacy to carbamazepine 300 to 1400 mg/day and phenytoin 300 mg/day against partial onset seizures and idiopathic generalised tonic-clonic seizures in adults with newly diagnosed epilepsy, and appears to be better tolerated than the older agents. As adjunctive therapy, lamotrigine (50 to 500 mg/day) has shown efficacy in short term ( < or = 6-months) placebo-controlled studies in adults with refractory partial epilepsy, reducing total seizure frequency (by < or = 60%) and producing improvement ( > or = 50% reduction in seizure frequency) in < or = 67% of patients. Both simple and complex partial seizures and secondarily generalised tonic-clonic seizures are reduced by lamotrigine, with generalised seizures (particularly absence seizures, atonic seizures and Lennox-Gastaut syndrome) tending to be more responsive than partial seizures. This reduction in seizure frequency is sustained on long term ( < or = 3 years) therapy and is reportedly accompanied by an improvement in psychological well-being. In children with refractory multiple seizure types, lamotrigine ( < or = 15 mg/kg/day; 400 mg/day) has proved effective as add-on therapy, with approximately equal to 40% of patients showing > or = 50% reductions in seizure frequency and approximately equal to 10 % achieving abolition of seizures after 3 months' treatment. Generalised seizures, including atypical and typical absence seizures, atonic and tonic seizures and Lennox-Gastaut syndrome are most responsive. The most common adverse events associated with lamotrigine are primarily neurological, gastrointestinal and dermatological. Maculopapular or erythematous skin rash, occasionally severe, occurs in approximately equal to 10% of patients and is the most common cause of treatment withdrawal. The risk of rash can, however, be minimised through adoption of a low, slow dosage titration schedule on initiating therapy. As monotherapy, lamotrigine produces less drowsiness than carbamazepine or phenytoin, and less asthenia and ataxia than phenytoin. Clinical experience would therefore suggest that lamotrigine is a particularly effective and generally well tolerated broad-spectrum agent for adjunctive treatment of both partial epilepsy and idiopathic generalised epilepsy in adults and children. Initial indications point to the drug filling an increasingly important future role in the monotherapy of newly diagnosed epilepsy.
MESH: Adult-; Aged-; Anticonvulsants-adverse-effects; Anticonvulsants-pharmacology; Child-; Child,-Preschool; Triazines-adverse-effects; Triazines-pharmacology
MESH: *Anticonvulsants-therapeutic-use; *Epilepsy-drug-therapy; *Triazines-therapeutic-use
TG: Comparative-Study; Human
PT: JOURNAL-ARTICLE; REVIEW; REVIEW,-TUTORIAL
RN: 0; 0; 84057-84-1
NM: Anticonvulsants; Triazines; lamotrigine
AN: 96106622
UD: 9604
MEDLINE EXPRESS (R) 1/96-11/96 15 of 26
TI: [Early infantile epileptic encephalopathy]
TO: Encefalopatia epileptica infantil precoz.
AU: Martinez-Bermejo-A; Roche-C; Lopez-Martin-V; Pascual-Castroviejo-I
AD: Servicio de Neuropediatria, Hospital La Paz, Facultad de Medicina, Universidad Autonoma, Madrid.
SO: Rev-Neurol. 1995 Mar-Apr; 23(120): 297-300
ISSN: 0210-0010
PY: 1995
LA: SPANISH; NON-ENGLISH
CP: SPAIN
AB: Early infantile epileptic encephalopathy (EIEE) with burst-suppression (Ohtaharas syndrome) is a rare type of epileptic encephalopathy in infancy and represents the earliest type of age-related symptomatic generalised epilepsy. We present 4 cases of EIEE fulfilling the classic diagnostic criteria, excluding the cases with segmentary and erratic myoclonic, characteristic features of Early Myoclonic Encephalopathy. All the patients were females. Pregnancy and delivery were normal and no other cases were observed in the families. One of the patients had a normal twin brother. Seizures began in all the cases before the 10th day of life. The initial EEG showed burst-suppression pattern, lasting for an average of 2.3 months of age (1.5-4 months). Seizures were initially resistant to therapy, although 2 cases showed partial response. None of the patients evolved to West syndrome. A case died at 5 months of age. No etiologic factors were found in two cases, but hemimegalencephaly was detected in the other two patients; in one of them seizures disappeared after corticectomy. We believe EIEE constitutes a type of epileptic encephalopaty which can be distinguished from other types of early onset epilepsy and should be included in the International Classification of Epilepsies with the West and Lennox-Gastaut syndromes.
MESH: Age-of-Onset; Child-; Child,-Preschool; Electroencephalography-; English-Abstract; Epilepsy,-Myoclonic-diagnosis; Laterality-; Syndrome-
MESH: *Brain-abnormalities; *Brain-physiopathology; *Epilepsy,-Myoclonic-physiopathology
TG: Case-Report; Female; Human
PT: JOURNAL-ARTICLE
AN: 96085408
UD: 9603
MEDLINE EXPRESS (R) 1/96-11/96 16 of 26
TI: Management issues in severe childhood epilepsies.
AU: Wallace-SJ
AD: University Hospital of Wales, Health Park, Cardiff, UK.
SO: Seizure. 1995 Sep; 4(3): 215-20
ISSN: 1059-1311
PY: 1995
LA: ENGLISH
CP: ENGLAND
AB: The severe epilepsies of childhood are described briefly and information available on the efficacy of newly developed antiepileptic drugs (AEDs) in their control is reviewed. Therapeutic advances are awaited for early infantile epileptic encephalopathy, early myoclonic encephalopathy, progressive myoclonus epilepsies and Kojewnikow syndrome. West syndrome may respond to vigabatrin, and less predictably to lamotrigine. Lamotrigine can be helpful for severe myoclonic epilepsy and myoclonic absences. Astatic seizures may be dramatically controlled by lamotrigine, whereas vigabatrin may worsen myoclonic attacks. In the Lennox-Gastaut syndrome, the efficacy of felbamate has been demonstrated by a controlled trial; vigabatrin and lamotrigine can also be helpful. Non-idiopathic partial and secondary generalized epilepsies are responsive to vigabatrin in a useful percentage of cases, and some children improve with felbamate, lamotrigine or striripentol. A trial which compares the efficacies of the newer AEDs against each other could provide very useful information for the clinician.
MESH: Adolescence-; Anticonvulsants-adverse-effects; Child-; Child,-Preschool; Drug-Administration-Schedule; Drug-Therapy,-Combination; Electroencephalography-drug-effects; Epilepsy-classification; Epilepsy-etiology; Infant-; Syndrome-; Treatment-Outcome
MESH: *Anticonvulsants-therapeutic-use; *Epilepsy-drug-therapy
TG: Female; Human; Male
PT: JOURNAL-ARTICLE; REVIEW; REVIEW,-TUTORIAL
RN: 0
NM: Anticonvulsants
AN: 96025542
UD: 9602
MEDLINE EXPRESS (R) 1991-1995 17 of 26
TI: Non-convulsive status epilepticus.
AU: Stores-G; Zaiwalla-Z; Styles-E; Hoshika-A
AD: University of Oxford, Department of Psychiatry, Park Hospital for Children, Headington.
SO: Arch-Dis-Child. 1995 Aug; 73(2): 106-11
ISSN: 0003-9888
PY: 1995
LA: ENGLISH
CP: ENGLAND
AB: The clinical, electrographic and reported neuropsychological features of 50 children with non-convulsive status epilepticus (NCSE) were reviewed and the children's progress followed for one to five years. NCSE occurred in a variety of epilepsies, especially the Lennox-Gastaut syndrome. Clinical manifestations ranged from obvious mental deterioration to subtle changes. The condition had often been overlooked or misinterpreted and many children had experienced repeated episodes over long periods. Following diagnosis, immediate treatment was often not attempted or was not successful. Further episodes of NCSE occurred in the majority of children during the follow up period. Failure to recognise NCSE and to treat episodes promptly, and the high rate of recurrence, is of particular concern in view of fears that repeated exposure to this condition might be brain damaging. At least 28 children in the present series showed evidence of intellectual or educational deterioration over the period during which NCSE had occurred, although the exact cause was difficult to determine.
MESH: Adolescence-; Child-; Child-Behavior-Disorders-etiology; Child,-Preschool; Diazepam-therapeutic-use; Electroencephalography-; Follow-Up-Studies; Learning-Disorders-etiology; Recurrence-; Retrospective-Studies; Status-Epilepticus-drug-therapy; Status-Epilepticus-psychology
MESH: *Status-Epilepticus-diagnosis
TG: Female; Human; Male
PT: JOURNAL-ARTICLE
RN: 439-14-5
NM: Diazepam
AN: 96005745
UD: 9601
SB: AIM
MEDLINE EXPRESS (R) 1991-1995 18 of 26
TI: Lamotrigine: clinical experience in 93 patients with epilepsy.
AU: Buchanan-N
AD: Epilepsy Unit, Westmead Hospital, University of Sydney, Australia.
SO: Acta-Neurol-Scand. 1995 Jul; 92(1): 28-32
ISSN: 0001-6314
PY: 1995
LA: ENGLISH
CP: DENMARK
AB: This open study reports the use of lamotrigine in 93 adults and children with drug resistant epilepsy. Lamotrigine was used predominantly as add-on therapy and outcome was assessed by the patient, parents and carers and the physician in terms of reduction of seizure frequency, drug side effects, and importantly with this drug, improvement in quality of life. Twenty five of the 93 patients (26.9%) studied were rendered seizure free with the addition of lamotrigine to their therapy. This was especially the case for patients with complex partial seizures, generalised seizures secondary to brain damage, primary generalised epilepsy and the Lennox Gastaut syndrome. Quality of life improvements were especially striking in patients with seizures secondary to brain damage and in the Lennox Gastaut Syndrome. Twenty eight patients ceased lamotrigine, 13 due to lack of effect and the remainder due to side effects. Lamotrigine is a potentially very useful anti-epileptic medication in persons with complex partial seizures, but also in primary generalised epilepsy, the Lennox Gastaut syndrome and especially in those individuals who have seizures subsequent to brain damage.
MESH: Adult-; Anticonvulsants-adverse-effects; Child-; Dose-Response-Relationship,-Drug; Drug-Administration-Schedule; Drug-Therapy,-Combination; Electroencephalography-drug-effects; Evoked-Potentials-drug-effects; Quality-of-Life; Treatment-Outcome; Triazines-adverse-effects
MESH: *Anticonvulsants-therapeutic-use; *Epilepsy-drug-therapy; *Triazines-therapeutic-use
TG: Female; Human; Male
PT: JOURNAL-ARTICLE
RN: 0; 0; 84057-84-1
NM: Anticonvulsants; Triazines; lamotrigine
AN: 96040465
UD: 9601
MEDLINE EXPRESS (R) 1991-1995 19 of 26
TI: [Anticonvulsive drug therapy. Historical and current aspects]
TO: Medikamentose antikonvulsive Therapie. Historische und aktuelle Aspekte.
AU: Bauer-J; Elger-CE
AD: Klinik fur Epileptologie, Rheinische Friedrich-Wilhelms-Universitat Bonn.
SO: Nervenarzt. 1995 Jun; 66(6): 403-11
ISSN: 0028-2804
PY: 1995
LA: GERMAN; NON-ENGLISH
CP: GERMANY
AB: The development of new antiepileptic drugs in recent years has enlarged the number of anticonvulsant compounds for the treatment of intractable focal epilepsies. The anticonvulsant potency of these drugs is usually compared by the number of patients who achieve a reduction in seizure frequency of more than 50%. Such an effect can be observed in approximately 20-30% of patients with pharmacoresistant focal epilepsies and is about the same with all the new compounds. In addition to the influence on focal seizures some of the novel anticonvulsant drugs exhibit efficacy in generalized seizures or in Lennox-Gastaut syndrome. In general there are fewer side effects in newly developed drugs than in standard anticonvulsants. However, in some cases characteristic side effects may occur: weight gain, depression or psychosis from vigabatrin; lamotrigine may provoke allergic rashes and felbamate may cause gastrointestinal side effects and sleeplessness. Apart from felbamate, there are no interactions with an antiepileptic comedication or they are of little importance. The development of the new anticonvulsants follows a rational design based on pathophysiological aspects: the main aim is to influence synaptic transmission, resulting in an increase in inhibitory and a decrease in excitatory transmitters. Thus, vigabatrin and tiagabine enhance the endogenous GABA amount, whereas felbamate and remacemide interact with the NMDA-receptor complex. Because it is not possible to draw sufficient conclusions from add-on studies in clinical testing it is necessary to establish new forms of trial design. Monotherapy designs are favored because they lack possible interactions with comedication and make the anticonvulsant efficacy of the compound better comparable to those of established anticonvulsants.(ABSTRACT TRUNCATED AT 250 WORDS)
MESH: Anticonvulsants-adverse-effects; Brain-drug-effects; Brain-physiopathology; Drug-Therapy,-Combination; Electroencephalography-drug-effects; English-Abstract; Epilepsy-physiopathology; Epilepsy,-Generalized-drug-therapy; Epilepsy,-Generalized-physiopathology; Epilepsy,-Partial-drug-therapy; Epilepsy,-Partial-physiopathology; GABA-physiology; Ion-Channels-drug-effects; Ion-Channels-physiology; Neural-Inhibition-drug-effects; Neural-Inhibition-physiology; Receptors,-N-Methyl-D-Aspartate-drug-effects; Receptors,-N-Methyl-D-Aspartate-physiology; Synaptic-Transmission-drug-effects; Synaptic-Transmission-physiology
MESH: *Anticonvulsants-therapeutic-use; *Epilepsy-drug-therapy
TG: Animal; Human
PT: JOURNAL-ARTICLE; REVIEW; REVIEW,-TUTORIAL
RN: 0; 0; 0; 56-12-2
NM: Anticonvulsants; Ion-Channels; Receptors,-N-Methyl-D-Aspartate; GABA
AN: 95364973
UD: 9511
MEDLINE EXPRESS (R) 1991-1995 20 of 26
TI: Thyrotropin-releasing hormone in treatment of intractable epilepsy: neurochemical analysis of CSF monoamine metabolites.
AU: Takeuchi-Y; Tominaga-M; Mitsufuji-N; Yamazoe-I; Kawase-S; Nishimura-A; Matsuo-S; Sawada-T
AD: Department of Pediatrics, Kyoto Prefectural University of Medicine, Japan.
SO: Pediatr-Neurol. 1995 Feb; 12(2): 139-45
ISSN: 0887-8994
PY: 1995
LA: ENGLISH
CP: UNITED-STATES
AB: The efficacy of thyrotropin-releasing hormone in children with intractable epilepsy was investigated and changes in cerebrospinal fluid monoamine metabolites were analyzed. The 18 patients had either West syndrome (12 patients) or Lennox-Gastaut syndrome (6 patients), which was intractable to antiepileptic drug therapy and to adrenocorticotrophic hormone. Thyrotropin-releasing hormone-tartrate was administered for 4 weeks. Before and after the thyrotropin-releasing hormone administration, cerebrospinal fluid was collected and analyzed for 5-hydroxyindoleacetic acid, kynurenine, homovanillic acid, and 3-methoxy-4-hydroxyphenyl glycol. The patients were classified into 3 groups, based on seizure frequency and electroencephalographic effects: cessation of seizures and seizure discharges (very effective; group A), reduction of seizures and/or seizure discharges (effective; group B), and no changes in frequency of seizures or discharges (not effective; group C). There were 6 patients in group A, 3 in group B, and 9 in group C. There were no significant differences in monoamine metabolites before and after the thyrotropin-releasing hormone therapy. A trial of thyrotropin-releasing hormone for the treatment of intractable epilepsy is warranted and further study is required on the mechanism of the antiepileptic action of thyrotropin-releasing hormone.
MESH: Child-; Child,-Preschool; Electroencephalography-drug-effects; Epilepsy-cerebrospinal-fluid; Homovanillic-Acid-cerebrospinal-fluid; Hydroxyindoleacetic-Acid-cerebrospinal-fluid; Infant-; Kynurenine-cerebrospinal-fluid; Methoxyhydroxyphenylglycol-cerebrospinal-fluid; Protirelin-adverse-effects; Spasms,-Infantile-cerebrospinal-fluid; Treatment-Outcome
MESH: *Epilepsy-drug-therapy; *Neurotransmitters-cerebrospinal-fluid; *Protirelin-therapeutic-use; *Spasms,-Infantile-drug-therapy
TG: Female; Human; Male; Support,-Non-U.S.-Gov't
PT: JOURNAL-ARTICLE
RN: 0; 24305-27-9; 306-08-1; 343-65-7; 534-82-7; 54-16-0
NM: Neurotransmitters; Protirelin; Homovanillic-Acid; Kynurenine; Methoxyhydroxyphenylglycol; Hydroxyindoleacetic-Acid
AN: 95298139
UD: 9509
MEDLINE EXPRESS (R) 1991-1995 21 of 26
TI: Felbamate, a novel antiepileptic drug, reverses N-methyl-D-aspartate/glycine-stimulated increases in intracellular Ca2+ concentration.
AU: Taylor-LA; McQuade-RD; Tice-MA
AD: Schering-Plough Research Institute, Kenilworth, NJ 07033, USA.
SO: Eur-J-Pharmacol. 1995 Apr 28; 289(2): 229-33
ISSN: 0014-2999
PY: 1995
LA: ENGLISH
CP: NETHERLANDS
AB: Felbamate, 2-phenyl-1,3-propanediol dicarbamate, is a novel, orally active anticonvulsant that has recently been approved for the treatment of Lennox-Gastaut syndrome and partial onset seizures in the United States. Felbamate is active in a broad range of animal anticonvulsant tests. Although its mechanism of action has yet to be fully elucidated, felbamate appears to act by inhibiting the spread of seizures and elevating seizure threshold. One proposed mechanism of action for felbamate is via the NMDA receptor complex. Previous studies have demonstrated the ability of felbamate to inhibit glycine binding at the NMDA receptor complex. The present study examined the effects of felbamate on NMDA/glycine-stimulated increases in intracellular calcium (Ca2+) using cultured rat hippocampal neurons. The results of these experiments demonstrate that felbamate inhibits NMDA/glycine-stimulated increases in intracellular Ca2+ with a minimal effective concentration of 100 microM.
MESH: Cells,-Cultured; Dose-Response-Relationship,-Drug; Drug-Interactions; Glycine-pharmacology; Hippocampus-drug-effects; N-Methylaspartate-pharmacology; Rats-; Rats,-Sprague-Dawley; Receptors,-N-Methyl-D-Aspartate-drug-effects; Time-Factors
MESH: *Anticonvulsants-pharmacology; *Calcium-metabolism; *Propanediols-pharmacology
TG: Animal
PT: JOURNAL-ARTICLE
RN: 0; 0; 0; 25451-15-4; 56-40-6; 6384-92-5; 7440-70-2
NM: Anticonvulsants; Propanediols; Receptors,-N-Methyl-D-Aspartate; felbamate; Glycine; N-Methylaspartate; Calcium
AN: 95347429
UD: 9511
MEDLINE EXPRESS (R) 1991-1995 22 of 26
TI: Cortical dysgenesis: serial EEG findings in children and adults.
AU: Raymond-AA; Fish-DR; Boyd-SG; Smith-SJ; Pitt-MC; Kendall-B
AD: Department of Clinical Neurophysiology, National Hospital for Neurology and Neurosurgery, London, UK.
SO: Electroencephalogr-Clin-Neurophysiol. 1995 Jun; 94(6): 389-97
ISSN: 0013-4694
PY: 1995
LA: ENGLISH
CP: IRELAND
AB: Cortical dysgenesis (CD) is becoming increasingly recognised as a cause of epilepsy in otherwise cryptogenic cases. We describe the serial EEG findings in 22 patients with focal/localised CD. The EEGs covered a minimum period of 5 years in each case (median = 13 years, range: 5-30 years), beginning in childhood. Median age at seizure onset was 3 years (range: 3 weeks-10 years, n = 21). The EEG was normal in the one patient, a 6 year old, who did not have epilepsy. Background rhythms appropriate for age were preserved in the majority of patients (18/22). Slow activity localised to the area of CD was seen in 11 patients; in 3 patients, this did not appear until the second decade of life. Epileptiform discharges were seen in at least one EEG in 20 patients: these were continuous or near-continuous (6 patients) or occurred recurrently in short runs (6 patients). In 6 patients, these discharges appeared only after the second decade of life and in 11 patients, they became more widespread over time. In the remaining patients, the EEG changes did not evolve. Sleep failed to produce new abnormalities (n = 15). None of the patients showed EEG features characteristic of lissencephaly or evolution to the Lennox-Gastaut syndrome. Even in this selected cohort of patients who had undergone serial clinical EEGs, the EEG abnormalities in focal/localised CD appeared relatively stable and showed only moderate changes over time. CD must be included in the differential diagnosis of any patient who presents with localised slow activity on EEG.
MESH: Adolescence-; Adult-; Age-of-Onset; Brain-Diseases-diagnosis; Cerebral-Cortex-physiopathology; Cerebral-Cortex-radiography; Child-; Electroencephalography-; Epilepsy-etiology; Magnetic-Resonance-Imaging; Tomography,-X-Ray-Computed
MESH: *Brain-Diseases-physiopathology; *Cerebral-Cortex-abnormalities; *Epilepsy-physiopathology
TG: Female; Human; Male
PT: JOURNAL-ARTICLE
AN: 95331141
UD: 9510
MEDLINE EXPRESS (R) 1991-1995 23 of 26
TI: Vigabatrin in the management of generalized seizures in children.
AU: Appleton-RE
AD: Roald Dahl EEG Unit, Royal Liverpool Children's Hospital (Alder Hey), UK.
SO: Seizure. 1995 Mar; 4(1): 45-8
ISSN: 1059-1311
PY: 1995
LA: ENGLISH
CP: ENGLAND
AB: The interpretation of the results of the use of vigabatrin (VGB) in generalized seizures and epilepsies in children has been difficult. Most studies have assessed patients on the basis of both seizure type and epilepsy syndrome and the numbers of patients have been small. Some 'generalized' epilepsy syndromes (specifically the Lennox-Gastaut syndrome) are characterized by multiple seizure types which are frequently not analysed individually in terms of drug response. By contrast West syndrome is easier to evaluate as the spasms are the only, and characteristic, seizure type. Vigabatrin has been used as both add-on, and monotherapy in the treatment of spasms. The results of add-on studies suggest that symptomatic spasms respond best, with 40-100% of children becoming spasm-free and many others showing a reduction in seizures of over 50%. The limited, reported data on VGB-monotherapy in West syndrome have been encouraging with over 50% of patients experiencing a total and sustained control of seizures with minimal or no adverse events; however, the pattern of response (symptomatic cases responding better than cryptogenic cases), has not, as yet, been confirmed. The 'non-progressive' myoclonic epilepsies tend to be exacerbated with 25-50% of patients experiencing an increase in seizure frequency; this is an interesting observation in view of the improvement seen in infantile spasms, which are also classified as a myoclonic seizure. The use of VGB in other generalized seizures and epilepsy syndromes has been neither assessed, nor reported. This reflects the fact that these seizures/syndromes are easily and well controlled using the 'older' anti-epileptic drugs.
MESH: Anticonvulsants-adverse-effects; Child-; Child,-Preschool; Drug-Therapy,-Combination; Electroencephalography-adverse-effects; Epilepsy,-Myoclonic-chemically-induced; Epilepsy,-Myoclonic-drug-therapy; GABA-adverse-effects; GABA-therapeutic-use; Infant-; Spasms,-Infantile-drug-therapy
MESH: *Anticonvulsants-therapeutic-use; *Epilepsy,-Generalized-drug-therapy; *GABA-analogs-and-derivatives
TG: Human
PT: JOURNAL-ARTICLE; REVIEW; REVIEW,-TUTORIAL
RN: 0; 56-12-2; 60643-86-9
NM: Anticonvulsants; GABA; vigabatrin
AN: 95307845
UD: 9509
MEDLINE EXPRESS (R) 1991-1995 24 of 26
TI: The use of felbamate to treat infantile spasms.
AU: Hurst-DL; Rolan-TD
AD: Department of Neurology, Texas Tech University School of Medicine, Lubbock, USA.
SO: J-Child-Neurol. 1995 Mar; 10(2): 134-6
ISSN: 0883-0738
PY: 1995
LA: ENGLISH
CP: UNITED-STATES
AB: Based on the initial successful use of felbamate for infantile spasms in an infant with tuberous sclerosis, three additional infants with infantile spasms of different etiologies who had failed conventional therapies were treated with felbamate. Three of the four patients have shown complete resolution of infantile spasms. All responding patients did so within 1 week of starting felbamate. The one treatment failure had an initial reduction of seizure frequency and severity but has not maintained that response long term. Controlled studies are needed to firmly establish that felbamate is both safe and effective for the treatment of infantile spasms. As these cases document, felbamate is currently available for use in infantile spasms, and the frequent conversion of infantile spasms to Lennox-Gastaut syndrome, for which felbamate is approved, makes its use in infantile spasms logical.
MESH: Anticonvulsants-adverse-effects; Child,-Preschool; Dose-Response-Relationship,-Drug; Drug-Therapy,-Combination; Electroencephalography-drug-effects; Evoked-Potentials-drug-effects; Infant-; Propanediols-adverse-effects; Spasms,-Infantile-etiology
MESH: *Anticonvulsants-therapeutic-use; *Propanediols-therapeutic-use; *Spasms,-Infantile-drug-therapy
TG: Case-Report; Female; Human; Male
PT: JOURNAL-ARTICLE
RN: 0; 0; 25451-15-4
NM: Anticonvulsants; Propanediols; felbamate
AN: 95301862
UD: 9509
MEDLINE EXPRESS (R) 1991-1995 25 of 26
TI: Multifocal independent Spike syndrome: relationship to hypsarrhythmia and the slow spike-wave (Lennox-Gastaut) syndrome.
AU: Kotagal-P
AD: Section of Pediatric Epilepsy, Cleveland Clinic Foundation, Ohio 44195.
SO: Clin-Electroencephalogr. 1995 Jan; 26(1): 23-9
ISSN: 0009-9155
PY: 1995
LA: ENGLISH
CP: UNITED-STATES
AB: During a 3 year period EEGs were performed in 64 children with multifocal independent spikes (MIS), 17 with slow spike-wave complexes (SSWC), 22 with MIS and SSWC and 15 with hypsarrhythmia. Only EEG records containing adequate wakefulness and sleep were analyzed in 40 children with two or more serial EEGs at least 5 months apart. Transitions from one pattern to another occurred in 25/40 patients, consistent in all cases with the following sequence: Hypsarrythmia-->MIS-->MIS and generalized discharges-->SSWC. Patients with and without transitions did not differ in their age at presentation or duration of follow-up. Eleven of 12 patients whose initial EEG showed hypsarrhythmia or multifocal independent spikes underwent transitions, compared to 0/8 patients with SSWC (p < 0.001), indicating that SSWC is a stable pattern in children. Over a 6 month period, we also prospectively analyzed EEGs of 20 patients with multifocal spikes, hypsarrhythmia, and slow spike-wave complexes. Sleep activated additional spike foci, increased the frequency of generalized spike discharges and produced synchronization of bitemporal and bifrontal spike-wave discharges at 1.5-2.5 Hz the same as SSWC.
MESH: Adolescence-; Adult-; Child-; Child,-Preschool; Infant-; Prospective-Studies; Retrospective-Studies
MESH: *Electroencephalography-; *Epilepsy,-Absence-physiopathology; *Epilepsy,-Generalized-physiopathology; *Spasms,-Infantile-physiopathology
TG: Female; Human; Male
PT: JOURNAL-ARTICLE
AN: 95188392
UD: 9506
MEDLINE EXPRESS (R) 1991-1995 26 of 26
TI: A dysbalanced immune system in cryptogenic Lennox-Gastaut syndrome.
AU: van-Engelen-BG; Weemaes-CM; Renier-WO; Bakkeren-JA; Borm-GF; Strengers-PF
AD: Department of Paediatrics, University Hospital, Nijmegen, The Netherlands.
SO: Scand-J-Immunol. 1995 Feb; 41(2): 209-13
ISSN: 0300-9475
PY: 1995
LA: ENGLISH
CP: ENGLAND
AB: In children with cryptogenic Lennox-Gastaut syndrome we found a functionally impaired humoral immune response to a primary antigen (haemocyanin), despite signs of a triggered immune system consisting of elevated IgG concentrations. This combination of immunological findings, considered to be the expression of a dysbalanced-triggered as well as functionally impaired-immune system, has also been described in an auto-immune disease like systemic lupus erythaematodes in humans, and in genetically epilepsy-prone rats. The interactions between the immune system and the nervous system in Lennox-Gastaut syndrome will be discussed.
MESH: Adolescence-; Child-; Child,-Preschool; Hemocyanin-immunology; IgA-blood; IgG-blood; IgM-blood; Infant-; Syndrome-
MESH: *Epilepsy,-Absence-immunology; *Immunoglobulin-Isotypes-blood
TG: Female; Human; Male; Support,-Non-U.S.-Gov't
PT: JOURNAL-ARTICLE
RN: 0; 0; 0; 0; 9013-72-3
NM: IgA; IgG; IgM; Immunoglobulin-Isotypes; Hemocyanin
AN: 95167421
UD: 9505