Abstract:
:The incidence of new-onset epilepsy is higher among the elderly, the most rapidly growing segment of the population, than in any other age group. New-onset seizures in elderly patients are typically cryptogenic or symptomatic partial seizures that require long-term treatment. Because seizures in the elderly are often readily controlled, considerations of tolerability and safety, including pharmacokinetics and the potential for drug interactions, may be as important as efficacy in the selection of an antiepileptic drug (AED). The newer AEDs introduced during the past decade offer advantages in this respect over older agents. Phenytoin is the most widely used AED in the United States, but its hepatic metabolism and associated enzyme induction, as well as its nonlinear pharmacokinetics, are particular disadvantages for elderly patients. Because of their potential effects on cognitive function, sedating AEDs such as phenobarbital and primidone have little place in the treatment of new-onset seizures in elderly patients. Carbamazepine also is an enzyme-inducing agent with significant potential for drug interactions. Among the newer AEDs, gabapentin and levetiracetam have good safety and cognitive effect profiles and do not interact with other drugs, and lamotrigine offers many of the same benefits. Oxcarbazepine has better tolerability than carbamazepine, and topiramate and zonisamide, although they have more cognitive side effects than the other new AEDs, can be considered for some elderly patients. Forthcoming data from the Veterans Affairs Cooperative Trial 428, as well as recent guidelines from the American Academy of Neurology and the American Epilepsy Society, are likely to provide support for the use of selected second-generation AEDs as first-line agents for the treatment of epilepsy in elderly patients.
journal_name
Neurologyjournal_title
Neurologyauthors
Bergey GKdoi
10.1212/wnl.63.10_suppl_4.s40subject
Has Abstractpub_date
2004-11-23 00:00:00pages
S40-8issue
10 Suppl 4eissn
0028-3878issn
1526-632Xpii
63/10_suppl_4/S40journal_volume
63pub_type
杂志文章,评审相关文献
NEUROLOGY文献大全abstract::Of 53 patients with drug-induced seizures seen in the last decade, 45% had single seizures, 40% had multiple convulsions, and 15% had status epilepticus. Generalized seizures with focal features were common, but simple partial (motor) seizures occurred in only two patients. Isoniazid, insulin, lidocaine, and psychotro...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.34.12.1582
更新日期:1984-12-01 00:00:00
abstract:OBJECTIVE:To evaluate the risk of recurrent intracranial hemorrhage (ICH) in patients on vitamin K antagonists (VKAs) after a first episode of ICH. METHODS:The Cerebral Haemorrhage in patients Restarting Oral Anticoagulant Therapy (CHIRONE) Study collected data of patients eligible for the study from the database of 2...
journal_title:Neurology
pub_type: 杂志文章,多中心研究
doi:10.1212/WNL.0000000000000245
更新日期:2014-03-25 00:00:00
abstract::Outcome after carpal tunnel surgery was studied retrospectively in 32 patients with peripheral neuropathy and carpal tunnel syndrome. Nocturnal paresthesias were almost universally relieved, followed in order of responsiveness by pain, numbness, and weakness. Twenty-five of 28 patients said they would have the surgery...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.49.4.1159
更新日期:1997-10-01 00:00:00
abstract:OBJECTIVE:We tested the hypothesis that admission serum magnesium levels are associated with hematoma volume, hematoma growth, and functional outcomes in patients with intracerebral hemorrhage (ICH). METHODS:Patients presenting with spontaneous ICH were enrolled in an observational cohort study that prospectively coll...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0000000000004249
更新日期:2017-08-22 00:00:00
abstract:OBJECTIVES:We hypothesized that integrated motor-visual functions measured by manipulative manual dexterity are affected by white matter lesion (WML) burden as measured on cranial MRI across relevant brain regions in subjects at risk of preclinical occult vascular disease. METHODS:A real-time cross-sectional study of ...
journal_title:Neurology
pub_type: 杂志文章,随机对照试验
doi:10.1212/WNL.0000000000001557
更新日期:2015-05-12 00:00:00
abstract::Dialysis encephalopathy is a progressive, fatal condition that occurs in patients receiving hemodialysis. It is characterized by abnormalities in speech, myoclonic jerks, and striking changes on the electroencephalogram. We observed dramatic reversal of the clinical symptoms and electroencephalographic abnormalities i...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.26.12.1130
更新日期:1976-12-01 00:00:00
abstract:OBJECTIVE:To assess hearing in patients with essential tremor (ET) vs patients with Parkinson disease (PD) and normal controls. METHODS:The authors assessed demographic and clinical information including use of hearing aids in 250 patients with ET, 127 patients with PD, and 127 normal controls. The authors administere...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/01.wnl.0000086376.40750.af
更新日期:2003-10-28 00:00:00
abstract:OBJECTIVE:To address the role of cell death regulatory genes of the bcl-2 and caspase families in the neuropathology of human epilepsy using tissue extracted from patients undergoing temporal lobectomy for intractable seizures. METHODS:Using Western blotting and immunohistochemistry, the authors investigated the expre...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.55.2.250
更新日期:2000-07-25 00:00:00
abstract:OBJECTIVE:To determine whether patients with Alzheimer disease (AD) compensate for neuropathologic changes when performing a mnemonic task by recruiting 1) the same brain regions as age-matched, healthy controls, but to a greater extent; 2) additional brain regions not activated by controls; or 3) both. METHODS:Twelve...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/01.wnl.0000237534.31734.1b
更新日期:2006-09-26 00:00:00
abstract:OBJECTIVE:To review the disciplinary process by which the American Academy of Neurology (AAN) enforces its formalized standards of professional conduct. METHODS:We reviewed the AAN's Disciplinary Action Policy. We tracked the elapsed time from receipt to final decision of all allegations ("complaints") of improper con...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0b013e318202014e
更新日期:2010-12-14 00:00:00
abstract:BACKGROUND:The histopathology of AIDS-associated myelopathy (AM) closely resembles that of myelopathies due to cobalamin or folate deficiency, with white matter vacuolization in the spinal cord. The pathogenesis of AM appears unrelated to direct HIV infection of the spinal cord. There is abnormal trans-methylation meta...
journal_title:Neurology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1212/01.wnl.0000140469.18782.05
更新日期:2004-10-12 00:00:00
abstract:BACKGROUND:The clinical characteristics of Tourette syndrome (TS) present challenges for the systematic determination of whether individuals are affected and severity. Vocal and motor tics wax and wane, decrease over time, and may be voluntarily suppressible, and therefore may be absent at interview. Current instrument...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.53.9.2108
更新日期:1999-12-10 00:00:00
abstract:OBJECTIVE:In addition to the main multiple sclerosis (MS) major histocompatibility complex (MHC) risk allele (HLA DRB1*1501), investigations of the MHC have implicated several class I MHC loci (HLA A, HLA B, and HLA C) as potential independent MS susceptibility loci. Here, we evaluate the role of 3 putative protective ...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0b013e3181ed9c9c
更新日期:2010-08-17 00:00:00
abstract::A 25-year-old man with a long history of temporal lobe epilepsy developed right occipital lobe seizures and a progressive right homonymous hemianopia. MRI showed diffuse enhancement of the left temporoparieto-occipital white matter and cortical thickening of the left medial temporal lobe. The resected temporal lobe re...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.52.3.654
更新日期:1999-02-01 00:00:00
abstract:OBJECTIVE:To assess the possible abnormalities in the baroreflex modulation of both the heart and the arterial vasculature, in order to better evaluate the role of baroreflex abnormalities in the generation of the cardiovascular symptoms and complications affecting the familial dysautonomia (FD) patient. METHODS:Twent...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/01.wnl.0000142034.92124.6a
更新日期:2004-10-26 00:00:00
abstract::We have performed positron emission tomography (PET) with 2-deoxy-2[18F]fluoro-D-glucose (FDG) in eight infants and children (aged 18 days to 5 years) with medically refractory epilepsy of neonatal onset. It was hypothesized that in at least some of these infants a surgical approach (focal resection, cerebral hemisphe...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.38.8.1178
更新日期:1988-08-01 00:00:00
abstract:OBJECTIVE:To test the accuracy of an equation in adult patients with status epilepticus that calculates the free concentration of serum valproic acid (fVPA) from the total concentration of serum valproic acid (tVPA) and serum albumin. METHODS:All adult patients with status epilepticus who were treated at a Swiss acade...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0000000000011000
更新日期:2021-01-05 00:00:00
abstract:BACKGROUND:Affective-motivational and sensory-discriminative aspects of pain were investigated in patients with mild to moderate Alzheimer disease (AD) and healthy elderly controls using the cold pressor test tolerance and repetitive stimuli of warmth and heat stimuli, evaluating the stimulus-response function. METHOD...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0000000000001465
更新日期:2015-04-14 00:00:00
abstract::Interictal and ictal fluorodeoxyglucose scans were obtained with positron CT from four patients with spontaneous recurrent partial seizures, one with epilepsia partialis continua, and one with a single partial seizure induced by electrical stimulation of the hippocampus. Ictal metabolic patterns were different for eac...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.33.4.400
更新日期:1983-04-01 00:00:00
abstract:OBJECTIVE:To measure white matter (WM) and gray matter (GM) atrophy and lesion load in a large population of patients with multiple sclerosis (MS) using a fully automated, operator-independent, multiparametric segmentation method. METHODS:The study population consisted of 597 patients with MS and 104 control subjects....
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/01.wnl.0000168837.87351.1f
更新日期:2005-07-26 00:00:00
abstract:BACKGROUND:Patients with ALS commonly exhibit pseudobulbar affect. METHODS:The authors conducted a multicenter, randomized, double-blind, controlled, parallel, three-arm study to test a defined combination of dextromethorphan hydrobromide (DM) and quinidine sulfate (Q) (AVP-923) for the treatment of pseudobulbar affec...
journal_title:Neurology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1212/01.wnl.0000142042.50528.2f
更新日期:2004-10-26 00:00:00
abstract:BACKGROUND:Transcranial contrast Doppler studies have shown an increased prevalence of right-to-left shunts in patients with migraine with aura compared with controls. The anatomy and size of these right-to-left shunts have never been directly assessed. METHODS:In a cross-sectional case-control study, the authors perf...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/01.wnl.0000179800.73706.20
更新日期:2005-11-08 00:00:00
abstract:OBJECTIVE:To evaluate whether the burden of deep and lobar lacunes differs between patients with intracerebral hemorrhage (ICH) with definite/probable cerebral amyloid angiopathy (CAA) per the Boston criteria and hypertensive small vessel disease (HTN-SVD; ICH in basal ganglia, thalami, brainstem). METHODS:We defined ...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0000000000004007
更新日期:2017-06-06 00:00:00
abstract::The present study sought to evaluate the validity and generality of the Mini-Mental State Examination (MMSE) and its subsection scores. We gave the MMSE and other neuropsychological tests to 51 patients with probable Alzheimer's disease. On the basis of correlational and factor analyses, overall performance on the MMS...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.40.12.1894
更新日期:1990-12-01 00:00:00
abstract::This nested case-control study assessed the putative protective effect of human herpesvirus-8 (HHV-8) against HIV-1-related dementia (dementia). The HHV-8 seropositivity of 210 male age- and HIV disease stage-matched cases and controls was compared. The overall HHV-8 seropositivity of 66% was similar among demented HI...
journal_title:Neurology
pub_type: 杂志文章,多中心研究
doi:10.1212/wnl.59.6.950
更新日期:2002-09-24 00:00:00
abstract::Migraine, especially migraine with aura (MA), is an established risk factor for ischemic lesions of the brain. Recent evidence has also linked migraine to a broader range of ischemic vascular disorders including angina, myocardial infarction, coronary revascularization, claudication, and cardiovascular mortality. The ...
journal_title:Neurology
pub_type: 杂志文章,评审
doi:10.1212/WNL.0b013e3181a71220
更新日期:2009-05-26 00:00:00
abstract:OBJECTIVE:To describe four patients with temporal lobe epilepsy with limbic encephalitis unrelated to neoplasm. METHODS:The authors performed a retrospective evaluation of patient data obtained during presurgical evaluation, with additional CSF analyses, serum analyses, and histopathologic investigations. RESULTS:The...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.55.12.1823
更新日期:2000-12-26 00:00:00
abstract:OBJECTIVE:The gradual development of cutaneous allodynia during the course of a migraine attack is commonly detected by quantitative sensory testing (QST) in migraineurs seeking secondary and tertiary medical help. In this study, the authors developed a questionnaire that tested the recollection of the patients on thei...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/01.wnl.0000183358.53939.38
更新日期:2005-11-08 00:00:00
abstract::Recurrent stroke is a major public health concern and new treatment strategies are needed. While modulation of the renin angiotensin aldosterone system (RAAS) has proven effective in reducing recurrent cardiac events, its role in preventing recurrent cerebrovascular events remains unclear. RAAS is both a circulating a...
journal_title:Neurology
pub_type: 杂志文章,评审
doi:10.1212/01.wnl.0000130360.21618.d0
更新日期:2004-07-27 00:00:00
abstract:OBJECTIVE:To evaluate possible abnormal increase in thalamic glutamate/glutamine levels for restless legs syndrome (RLS) indicating increased glutamatergic activity producing arousal that at night disrupts and shortens sleep. METHODS:(1)H MRS of the right thalamus was performed using a 1.5 T GE MRI scanner and the PRO...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0b013e318294b3f6
更新日期:2013-05-28 00:00:00