Abstract:
:Epilepsy is one of the most common and challenging neurologic disorders affecting children. Although various modalities exist to treat pediatric-onset seizures, seizures in 25% of children who are diagnosed as having epilepsy remain refractory to available therapies. Of the 8 new antiepileptic drugs (AEDs) (felbamate, gabapentin, lamotrigine, topiramate, tiagabine, levetiracetam, oxcarbazepine, and zonisamide), all but 2 (zonisamide and levetiracetam) have received Food and Drug Administration approval for adjunctive use in the pediatric population. However, most of the new AEDs used in adults have also been used in children, beyond the AEDs' approved indications. The ultimate goal of patient management is to choose the therapeutic option that provides the best chance of improving the patient's quality of life. Issues that relate to treatment choice include the likelihood of seizure recurrence, type and severity of seizures, available AED efficacies and toxicities, need for hematologic monitoring, ease of dosing, underlying medical conditions, medication interactions, urgency of initiating therapy, and cost. In this review, we discuss these issues for each of the 8 new AEDs; we also discuss the ketogenic diet and briefly review the older AEDs. Knowledge of the available AEDs will enable the practitioner to choose the best drug or drugs for individual patients.
journal_name
Mayo Clin Procjournal_title
Mayo Clinic proceedingsauthors
Jarrar RG,Buchhalter JRdoi
10.4065/78.3.359keywords:
subject
Has Abstractpub_date
2003-03-01 00:00:00pages
359-70issue
3eissn
0025-6196issn
1942-5546pii
S0025-6196(11)62056-9journal_volume
78pub_type
杂志文章,评审abstract::Unintentional intra-arterial injection of medication, either iatrogenic or self-administered, is a source of considerable morbidity. Normal vascular anatomical proximity, aberrant vasculature, procedurally difficult situations, and medical personnel error all contribute to unintentional cannulation of arteries in an a...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/S0025-6196(11)61533-4
更新日期:2005-06-01 00:00:00
abstract:OBJECTIVE:To estimate the 3-month cumulative incidence of thromboembolism (TE), bleeding, and death among consecutive patients with nonvalvular atrial fibrillation (AF) who were receiving long-term anticoagulation therapy and were referred to the Thrombophilia Center at Mayo Clinic for periprocedural anticoagulation ma...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/83.6.639
更新日期:2008-06-01 00:00:00
abstract::During the past 16 years, in which 1,600 patients were surgically treated for primary hyperparathyroidism, 10 of these patients also were operated on for hypernephroma; in another patient a hypernephroma was detected 7 2/3 years after treatment for hyperparathyroidism. Four additional patients have elevated serum calc...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
更新日期:1982-11-01 00:00:00
abstract::Migraine, an episodic headache disorder, is one of the most common complaints encountered by primary-care physicians and neurologists. Nevertheless, it remains underdiagnosed and undertreated. Rational migraine treatment necessitates an accurate diagnosis, identification and removal of potential triggering factors, an...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.4065/71.11.1055
更新日期:1996-11-01 00:00:00
abstract::The introduction of transesophageal echocardiography has provided a new acoustic window to the heart and mediastinum. High-quality images of certain cardiovascular structures [left atrial appendage, thoracic aorta, mitral valvular apparatus, and atrial septum] can be obtained readily (average examination, 15 to 20 min...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/s0025-6196(12)65529-3
更新日期:1988-07-01 00:00:00
abstract::Crohn's disease can involve any portion of the digestive tract, but isolated gastric Crohn's disease is a rare entity. In the few previously reported cases, the inflammatory disorder has involved only a portion of the stomach. Herein we describe a patient with diffuse involvement of the entire stomach and an associate...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)61750-9
更新日期:1989-07-01 00:00:00
abstract:OBJECTIVE:To analyze the relationship of ideal cardiovascular health to disease-specific death. PATIENTS AND METHODS:We used data from the Aerobics Center Longitudinal Study from October 9, 1987, to March 3, 1999, to estimate the prevalence of ideal cardiovascular health in 11,993 individuals (24.3% women) and to exam...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2012.07.015
更新日期:2012-10-01 00:00:00
abstract::Dual-chamber pacing improved hemodynamics acutely in a subset of patients with left ventricular (LV) dysfunction but conveyed no long-term symptomatic benefit in most. More recently, LV pacing and biventricular (multisite) pacing have been used to improve systolic contractility by altering the electrical and mechanica...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/S0025-6196(11)63225-4
更新日期:2001-08-01 00:00:00
abstract:OBJECTIVE:To describe current concepts in the diagnosis and treatment of brain metastases. RESULTS:More than 25% of all autopsy-proven brain metastases have a pulmonary source. Most brain metastases manifest with a combination of focal and generalized symptoms and signs. Typically, patients have subacute, progressive ...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/s0025-6196(12)61374-3
更新日期:1994-11-01 00:00:00
abstract::Type 2 diabetes mellitus (DM) is a major cardiovascular (CV) risk factor and, as such, is considered a coronary artery disease risk equivalent. Although glycemic control is associated with decreased CV events epidemiologically, many prospective clinical trials have failed to conclusively demonstrate that aggressive gl...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.4065/mcp.2010.0434
更新日期:2011-02-01 00:00:00
abstract::Patients with ectatic coronary arteries often have occlusion of the affected arteries. Because ectatic arteries are considered to have medial damage, they are normally assumed to have little capacity to constrict; therefore, spasm has not been considered a factor in the occlusive process. In two patients who had diffu...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)64787-9
更新日期:1985-12-01 00:00:00
abstract:OBJECTIVE:To investigate an association between tumor necrosis factors-alpha (TNFα) inhibitors or other immunosuppressants and the development of uveal and cutaneous melanoma. PATIENTS AND METHODS:We performed a retrospective incidence and case-control analysis of patients in Olmsted County, MN, who were diagnosed wit...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2018.11.033
更新日期:2019-07-01 00:00:00
abstract::Tobacco use is a global pandemic. The most common pharmacological treatments of tobacco use and dependence include nicotine replacement therapy and nonnicotine medications. Bupropion sustained release (SR) is the only first-line nonnicotine medication recommended by the US Public Health Service Clinical Practice Guide...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.4065/78.8.1020
更新日期:2003-08-01 00:00:00
abstract::Usual causes of intolerance to thyroxine sodium include coronary artery disease, advanced age, untreated adrenal insufficiency, and severe hypothyroidism. We describe 4 patients with iron deficiency anemia and primary hypothyroidism. After treatment with thyroxine sodium, these patients developed palpitations and feel...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
更新日期:2000-02-01 00:00:00
abstract::An unusual case of a capillary hemangioma of the filum terminale is presented. The successful removal returned the patient to an asymptomatic state. ...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
更新日期:1975-03-01 00:00:00
abstract:OBJECTIVE:To examine 45-year trends in time use and physical activity energy expenditure (PAEE) in a nationally representative sample of US mothers. PARTICIPANTS AND METHODS:We quantified time allocation to physical activity (PA), sedentary behaviors (SED), and PAEE from 1965 to 2010 in mothers with older children (MO...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2013.09.009
更新日期:2013-12-01 00:00:00
abstract::Recent experience with 40 patients with the Zollinger-Ellison syndrome at all Mayo Clinic suggests that traditional clinical criteria for diagnosis are often absent or invalid. Patients are younger have a shorter duration of symptoms, and often present without prior gastric surgery. Clinical, roentgenographic, and end...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
更新日期:1978-01-01 00:00:00
abstract::A 36-year-old man sought medical attention because of pressure in his head and distention of the veins in his neck. Physical examination disclosed a murmur of aortic insufficiency, and a chest roentgenogram showed a dilated ascending aorta. Two-dimensional echocardiography and angiography demonstrated a large intimal ...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)65202-1
更新日期:1986-02-01 00:00:00
abstract::Parasitic diseases affect more than 2 billion people globally and cause substantial morbidity and mortality, particularly among the world's poorest people. This overview focuses on the treatment of the major protozoan and helminth infections in humans. Recent developments in antiparasitic therapy include the expansion...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.4065/mcp.2011.0203
更新日期:2011-06-01 00:00:00
abstract::Susac syndrome (retinocochleocerebral vasculopathy) is a syndrome of unknown pathogenesis. The triad of multifocal encephalopathy, visual loss, and hearing loss is caused by microangiopathy of the brain, retina, and cochlea. The illness tends to be monophasic, and to our knowledge, recurrence after years of remission ...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.4065/76.9.958
更新日期:2001-09-01 00:00:00
abstract::The patient with a hypersensitive carotid sinus reflex and syncope may pose special challenges in evaluation and treatment. Specifically, although the finding of carotid sinus hypersensitivity may indeed indicate an exaggerated vagal tone that causes syncope, it may also be a chance association in a patient with synco...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/s0025-6196(12)62417-3
更新日期:1984-09-01 00:00:00
abstract::The neurologist has become increasingly involved in the multidisciplinary treatment of patients with chronic noncancer pain (CNP). Chronic noncancer pain affects a diverse patient population with multiple underlying diagnoses and associated therapies. Following the model of the American Board of Anesthesiology and the...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.4065/78.1.80
更新日期:2003-01-01 00:00:00
abstract::All women who enter menopause experience amenorrhea unless they receive hormone replacement therapy. In younger women, amenorrhea unrelated to pregnancy and lactation can be a distressing symptom. In addition to its psychologic morbidity, amenorrhea may be the manifesting feature of a wide array of anatomic and endocr...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.4065/72.12.1161
更新日期:1997-12-01 00:00:00
abstract:OBJECTIVE:To estimate the prevalence of unidentified chronic obstructive pulmonary disease (COPD) and determine the screening accuracy of the Lung Function Questionnaire (LFQ). PATIENTS AND METHODS:Cigarette smokers who had a smoking history of 10 or more pack-years and were aged 30 years or older were recruited from ...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,多中心研究
doi:10.4065/mcp.2010.0787
更新日期:2011-05-01 00:00:00
abstract::The first generation of multicenter randomized controlled trials of coronary artery bypass surgery vs medical treatment in the 1970s found survival advantage only in patients with left main coronary artery disease or with multiple risk factors. Over time, these results have remained reproducible and biologically plaus...
journal_title:Mayo Clinic proceedings
pub_type:
doi:10.4065/77.1.72
更新日期:2002-01-01 00:00:00
abstract:OBJECTIVE:To investigate the incidence and risk of adverse clinical outcomes in a "real-world" cohort of patients with atrial fibrillation (AF) anticoagulated with vitamin K antagonists (VKAs) from the Murcia AF Project in comparison with the warfarin arm of the randomized clinical trial (RCT) AMADEUS (Evaluating the U...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:10.1016/j.mayocp.2018.01.028
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVE:In this report, our goal was to summarize the current knowledge of the biochemical basis for the impaired DNA synthesis and neuropathy associated with vitamin B12 deficiency. MATERIAL AND METHODS:We reviewed the pertinent literature and our clinical experience with cobalamin deficiency. RESULTS:Studies have...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/s0025-6196(12)61046-5
更新日期:1994-02-01 00:00:00
abstract::Two entities of special interest in sleep disorders medicine are restless legs syndrome and periodic movements of sleep. Most patients with restless legs syndrome have periodic movements of sleep, but most patients with the nocturnal disorder do not have restless legs when awake. In both conditions, the underlying cau...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章,评审
doi:10.1016/s0025-6196(12)65163-5
更新日期:1990-07-01 00:00:00
abstract::Peritoneovenous shunt for intractable ascites was complicated by disseminated intravascular coagulation, which resulted in the death of the patient. Attention is called to this potentially serious complication. The cause of disseminated intravascular coagulation occurring after peritoneovenous shunt is uncertain. Pati...
journal_title:Mayo Clinic proceedings
pub_type: 杂志文章
doi:
更新日期:1978-08-01 00:00:00
abstract:OBJECTIVE:To evaluate the effects of treatment with fluticasone propionate vs placebo on bone, hypothalamic-pituitary-adrenal (HPA) axis function, and the eyes in patients with asthma. PATIENTS AND METHODS:This randomized, double-blind, placebo-controlled study of 160 patients with asthma who had minimal previous expo...
journal_title:Mayo Clinic proceedings
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.4065/79.4.458
更新日期:2004-04-01 00:00:00