MDR1 gene expression in brain of patients with medically intractable epilepsy.

Abstract:

:Why some patients with seizures are successfully treated with antiepileptic drugs (AEDs) and others prove medically intractable is not known. Inadequate intraparenchymal drug concentration is a possible mechanism of resistance to AEDs. The multiple drug resistance gene (MDR1) encodes P-glycoprotein, an energy-dependent efflux pump that exports planar hydrophobic molecules from the cell. If P-glycoprotein is expressed in brain of some patients with intractable epilepsy and AEDs are exported by P-glycoprotein, lower intraparenchymal drug concentrations could contribute to lack of drug response in such patients. Eleven of 19 brain specimens removed from patients during operation for intractable epilepsy had MDR1 mRNA levels > 10 times greater than those in normal brain, as determined by quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) method. Immunohistochemistry for P-glycoprotein from 14 of the patients showed increased staining in capillary endothelium in samples from epileptic patients as compared with staining in normal brain samples. In epileptic brain specimens with high MDR1 mRNA levels, expression of P-glycoprotein in astrocytes also was identified. Last, steady-state intracellular phenytoin (PHT) concentrations in MDR1 expressing neuroectodermal cells was one fourth that in MDR1-negative cells. MDR1 expression is increased in brain of some patients with medically intractable epilepsy, suggesting that the patients' lack of response to medication may be caused by inadequate accumulation of AED in brain.

journal_name

Epilepsia

journal_title

Epilepsia

authors

Tishler DM,Weinberg KI,Hinton DR,Barbaro N,Annett GM,Raffel C

doi

10.1111/j.1528-1157.1995.tb01657.x

subject

Has Abstract

pub_date

1995-01-01 00:00:00

pages

1-6

issue

1

eissn

0013-9580

issn

1528-1167

journal_volume

36

pub_type

杂志文章
  • Ripples on rolandic spikes: A marker of epilepsy severity.

    abstract:OBJECTIVE:Children with rolandic spikes may or may not have seizures, ranging from benign rolandic epilepsy to severe atypical rolandic epilepsy. We investigated whether ripples (80-250 Hz), superimposed on rolandic spikes in surface electroencephalography (EEG), can differentiate between different entities. METHODS:I...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/epi.13423

    authors: van Klink NE,van 't Klooster MA,Leijten FS,Jacobs J,Braun KP,Zijlmans M

    更新日期:2016-07-01 00:00:00

  • Effects of clobazam and its active metabolite on GABA-activated currents in rat cerebral neurons in culture.

    abstract:PURPOSE:The antiepileptic effects of clobazam, a 1,5-benzodiazepine, have been well documented in animal experiments and clinical trials. However, the drug's mechanisms of antiepileptic actions are still undetermined. The purpose of this study was to learn how clobazam and its active metabolite modulate gamma-aminobuty...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1157.1996.tb00643.x

    authors: Nakamura F,Suzuki S,Nishimura S,Yagi K,Seino M

    更新日期:1996-08-01 00:00:00

  • The value of early postictal EEG in children with complex febrile seizures.

    abstract:PURPOSE:To assess the usefulness of an early postictal EEG in neurologically normal children with complex febrile seizures. METHODS:We conducted a retrospective chart review of all neurologically normal children who were hospitalized over a period of 2.5 years after complex febrile seizures, and had an EEG up to 1 wee...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1157.2000.tb00143.x

    authors: Maytal J,Steele R,Eviatar L,Novak G

    更新日期:2000-02-01 00:00:00

  • Rational polypharmacy.

    abstract::The medical treatment of seizure disorders is a complex process, requiring extensive interaction and co-operation between physician and patient. The physician must have an accurate diagnosis of the patient's illness and a comprehensive understanding of seizures and seizure disorders. The physician must consider specif...

    journal_title:Epilepsia

    pub_type: 杂志文章,评审

    doi:10.1111/j.1528-1157.1995.tb05994.x

    authors: Ferrendelli JA

    更新日期:1995-01-01 00:00:00

  • Levetiracetam in the treatment of idiopathic generalized epilepsies.

    abstract::Since its introduction into clinical practice in 1999, levetiracetam, the S enantiomer of piracetam, has rapidly found a secure place, initially in the therapy of partial onset seizures and subsequently in the treatment of idiopathic generalized epilepsies (IGE). It has many of the properties of an "ideal" antiepilept...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1167.2005.00329.x

    authors: Grünewald R

    更新日期:2005-01-01 00:00:00

  • Optimal choice of antiseizure medication: Agreement among experts and validation of a web-based decision support application.

    abstract:OBJECTIVE:Optimal choice of antiseizure medication (ASM) depends on seizure type, syndrome, age, gender, comorbidities and co-medications. There are no fixed rules on how to weigh these factors; choices are subjective and experience-driven. We investigated agreement among experts in selecting ASM as monotherapy and use...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/epi.16763

    authors: Beniczky S,Rampp S,Asadi-Pooya AA,Rubboli G,Perucca E,Sperling MR

    更新日期:2021-01-01 00:00:00

  • Adult-onset idiopathic generalized epilepsy: clinical and behavioral features.

    abstract:PURPOSE:To identify and define clinical and behavioral features of patients with adult-onset idiopathic generalized epilepsy (IGE). METHODS:We reviewed the charts of 313 IGE patients at the NYU Comprehensive Epilepsy Center over the past 5 years to identify patients with adult onset (18 years old or older). We exclude...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1046/j.1528-1157.2001.14901.x

    authors: Cutting S,Lauchheimer A,Barr W,Devinsky O

    更新日期:2001-11-01 00:00:00

  • Acute cerebral microbleeds in refractory status epilepticus.

    abstract::Cerebral microbleeds (CMBs) are commonly found in patients with stroke and cerebral amyloid angiopathy. However, there have been no reports of CMBs or their acute appearance in patients with status epilepticus. Herein we describe two patients with refractory status epilepticus of uncertain origin. Both patients were p...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/epi.12113

    authors: Jeon SB,Parikh G,Choi HA,Lee K,Lee JH,Schmidt JM,Badjatia N,Mayer SA,Claassen J

    更新日期:2013-05-01 00:00:00

  • Altered behavior in experimental cortical dysplasia.

    abstract:PURPOSE:Developmental delay and cognitive impairment are common comorbidities in people with epilepsy associated with malformations of cortical development (MCDs). We studied cognition and behavior in an animal model of diffuse cortical dysplasia (CD), in utero irradiation, using a battery of behavioral tests for neuro...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1167.2011.03267.x

    authors: Zhou FW,Rani A,Martinez-Diaz H,Foster TC,Roper SN

    更新日期:2011-12-01 00:00:00

  • The contribution of tertiary centers to the quality of the diagnosis and treatment of epilepsy. Osservatorio Regionale per l'Epilessia (OREp), Lombardy.

    abstract:PURPOSE:A survey was made of a network of 14 epilepsy centers in Italy to assess whether integrated diagnosis and treatment monitoring led to a more precise syndromic classification of the patients and a better response to treatment. METHODS:Data on the diagnosis and treatment of epilepsy and the degree of seizure con...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1157.1997.tb00072.x

    authors:

    更新日期:1997-12-01 00:00:00

  • The new antiepileptic drugs and women: efficacy, reproductive health, pregnancy, and fetal outcome.

    abstract::As new antiepileptic drugs (AEDs) become available, physicians will define their appropriate use in particular patient populations. For women, the issues include gender-specific efficacy and tolerability, including the impact of the AED on reproductive health. Women with epilepsy who are treated with established AEDs ...

    journal_title:Epilepsia

    pub_type: 杂志文章,评审

    doi:10.1111/j.1528-1157.1996.tb06037.x

    authors: Morrell MJ

    更新日期:1996-01-01 00:00:00

  • A study of the pharmacokinetics of phenytoin (diphenylhydantoin) in epileptic patients, and the development of a nomogram for making dose increments.

    abstract::Phenytoin is metabolized to its parahydroxylated derivative by hepatic microsomal enzymes. This hydroxylation is a saturable process, that is, the rate of metabolism fails to increase in proportion to the serum concentration. This leads to a nonlinear relationship between the maintenance dose of the drug and the resul...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1157.1975.tb04745.x

    authors: Richens A

    更新日期:1975-11-01 00:00:00

  • Efficacy of clobazam as add-on therapy in patients with refractory partial epilepsy.

    abstract:PURPOSE:Clobazam (CLB) has an important antiepileptic effect and is less expensive than the new antiepileptic drugs (AEDs), but still has not been considered as first-line drug in the treatment of epilepsy. We evaluated the efficacy of CLB as add-on therapy in patients with refractory partial epilepsy. METHODS:This wa...

    journal_title:Epilepsia

    pub_type: 临床试验,杂志文章

    doi:10.1046/j.1528-1157.2001.31600.x

    authors: Montenegro MA,Cendes F,Noronha AL,Mory SB,Carvalho MI,Marques LH,Guerreiro CA

    更新日期:2001-04-01 00:00:00

  • The diagnostic utility of intracranial EEG monitoring for epilepsy surgery in children.

    abstract:OBJECTIVE:There are limited data on the indications for the use of chronic invasive electroencephalography (EEG) monitoring (IEM) for pediatric epilepsy surgery. METHODS:We retrospectively studied 102 children who underwent intracranial monitoring to map critical cortex, localize the epileptogenic region, or resolve d...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/epi.12983

    authors: Brna P,Duchowny M,Resnick T,Dunoyer C,Bhatia S,Jayakar P

    更新日期:2015-07-01 00:00:00

  • Development and persistence of kindled seizures after repeated injections of pentylenetetrazol in rats and guinea pigs.

    abstract::Pentylenetetrazol (PTZ) was injected into rats (30 or 35 mg/kg) and guinea pigs (40 or 45 mg/kg) daily or every second day. A progressive development of seizure activity after this treatment was observed. Doses ineffective after the first injection induced tonic seizures after 20 injections. Both kinds of treated anim...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1157.1984.tb03452.x

    authors: Diehl RG,Smialowski A,Gotwo T

    更新日期:1984-08-01 00:00:00

  • Severe myoclonic epilepsy of infants (Dravet syndrome): natural history and neuropsychological findings.

    abstract::Severe Myoclonic Epilepsy in infancy (SMEI, or Dravet syndrome) is a drug-resistant epilepsy that occurs in the first year of life of previously healthy children. The main clinical features are prolonged and repeated febrile and afebrile generalized or unilateral convulsive seizures. In the course of the epilepsy, cog...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1167.2006.00688.x

    authors: Wolff M,Cassé-Perrot C,Dravet C

    更新日期:2006-01-01 00:00:00

  • Refractory epilepsy: an evaluation of psychological methods in outpatient management.

    abstract::Two groups of adult outpatients (n = 19 and n = 21) with poorly controlled epilepsy and significant psychological disorder, assessed in terms of rating scales, received two psychological treatments in a balanced cross-over design after stable baseline seizure frequency had been established. A third group (n = 19), who...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1157.1990.tb05498.x

    authors: Gillham RA

    更新日期:1990-07-01 00:00:00

  • 22q11.2 deletion syndrome lowers seizure threshold in adult patients without epilepsy.

    abstract:OBJECTIVE:Previous studies examining seizures in patients with 22q11.2 deletion syndrome (22q11.2DS) have focused primarily on children and adolescents. In this study we investigated the prevalence and characteristics of seizures and epilepsy in an adult 22q11.2DS population. METHODS:The medical records of 202 adult p...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/epi.13748

    authors: Wither RG,Borlot F,MacDonald A,Butcher NJ,Chow EWC,Bassett AS,Andrade DM

    更新日期:2017-06-01 00:00:00

  • Risk factors for subsequent febrile seizures in the FEBSTAT study.

    abstract:OBJECTIVES:To identify risk and risk factors for developing a subsequent febrile seizure (FS) in children with a first febrile status epilepticus (FSE) compared to a first simple febrile seizure (SFS). To identify home use of rescue medications for subsequent FS. METHODS:Cases included a first FS that was FSE drawn fr...

    journal_title:Epilepsia

    pub_type: 杂志文章,多中心研究

    doi:10.1111/epi.13418

    authors: Hesdorffer DC,Shinnar S,Lax DN,Pellock JM,Nordli DR Jr,Seinfeld S,Gallentine W,Frank LM,Lewis DV,Shinnar RC,Bello JA,Chan S,Epstein LG,Moshé SL,Liu B,Sun S,FEBSTAT study team.

    更新日期:2016-07-01 00:00:00

  • Prevalence, classification, and severity of epilepsy in children in western Norway.

    abstract:PURPOSE:To determine prevalence of active epilepsy in school children in a defined area and assess the usefulness of International League Against Epilepsy classification of seizures and epileptic syndromes, with special emphasis on frequency, additional handicaps, and therapeutic problems of severe cases. METHODS:The ...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1157.2000.tb00246.x

    authors: Waaler PE,Blom BH,Skeidsvoll H,Mykletun A

    更新日期:2000-07-01 00:00:00

  • KCNT1-related epilepsy: An international multicenter cohort of 27 pediatric cases.

    abstract:OBJECTIVE:Through international collaboration, we evaluated the phenotypic aspects of a multiethnic cohort of KCNT1-related epilepsy and explored genotype-phenotype correlations associated with frequently encountered variants. METHODS:A cross-sectional analysis of children harboring pathogenic or likely pathogenic KCN...

    journal_title:Epilepsia

    pub_type: 杂志文章,多中心研究

    doi:10.1111/epi.16480

    authors: Borlot F,Abushama A,Morrison-Levy N,Jain P,Puthenveettil Vinayan K,Abukhalid M,Aldhalaan HM,Almuzaini HS,Gulati S,Hershkovitz T,Konanki R,Lingappa L,Luat AF,Shafi S,Tabarki B,Thomas M,Yoganathan S,Alfadhel M,Arya R,

    更新日期:2020-04-01 00:00:00

  • Sodium valproate associated with phenobarbital: effects on ammonia metabolism in humans.

    abstract::Treatment with sodium valproate (VPA) in association with phenobarbital (PB) is accompanied by a greater systemic hyperammonemia than treatment by VPA alone. The anatomical origins of this difference were studied by injecting a dose of 1,500 mg VPA i.v. into six unmedicated patients and six epileptics chronically trea...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1157.1983.tb03428.x

    authors: Warter JM,Marescaux C,Brandt C,Rumbach L,Micheletti G,Chabrier G,Imler M,Kurtz D

    更新日期:1983-10-01 00:00:00

  • Non-monoamine oxidase inhibitor antidepressants and epilepsy: a review.

    abstract::The literature dealing with the convulsant effects of the antidepressant drugs of the non-monoamine oxidase inhibitor variety is reviews. It is concluded that most of these drugs do lower the seizure threshold and may precipitate seizures even at normal therapeutic doses. The pathophysiology of antidepressant-induced ...

    journal_title:Epilepsia

    pub_type: 杂志文章,评审

    doi:10.1111/j.1528-1157.1978.tb04486.x

    authors: Trimble M

    更新日期:1978-06-01 00:00:00

  • Epilepsy duration, febrile seizures, and cerebral glucose metabolism.

    abstract:PURPOSE:Studies using magnetic resonance imaging have shown that reduced hippocampal volume is associated with a history of febrile seizures, the duration of epilepsy, and the number of generalized tonic-clonic seizures. It is uncertain whether these factors have the same influence on functional as on structural measur...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.0013-9580.2004.51803.x

    authors: Theodore WH,Kelley K,Toczek MT,Gaillard WD

    更新日期:2004-03-01 00:00:00

  • Effects of magnesium sulfate on pentylenetetrazol-induced status epilepticus.

    abstract::The use of magnesium sulfate (MgSO4) as an anticonvulsant is controversial. Status epilepticus was induced in 0.5% halothane-anesthetized Wistar rats with a threshold (90 mg/kg) or suprathreshold (200 mg/kg) dose of intravenous (i.v.) pentylenetetrazol (PTZ) under stereotactic hippocampal depth electrode monitoring. F...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1157.1991.tb04690.x

    authors: Link MJ,Anderson RE,Meyer FB

    更新日期:1991-07-01 00:00:00

  • Regional cerebral blood flow during temporal lobe seizures associated with ictal vomiting: an ictal SPECT study in two patients.

    abstract:PURPOSE:Ictal vomiting represents a rare clinical manifestation during seizures originating from the temporal lobes of the nondominant hemisphere. The precise anatomic structures responsible for generation of ictal vomiting remain to be clarified. Ictal single photon emission computed tomography (SPECT), which allows o...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1157.1999.tb00823.x

    authors: Baumgartner C,Olbrich A,Lindinger G,Pataraia E,Gröppel G,Bacher J,Aull S,Serles W,Hoffmann M,Leutmezer F,Czech T,Prayer D,Pietrzyk U,Asenbaum S,Podreka I

    更新日期:1999-08-01 00:00:00

  • Is inpatient ictal video-electroencephalographic monitoring mandatory in mesial temporal lobe epilepsy with unilateral hippocampal sclerosis? A prospective study.

    abstract:OBJECTIVE:To compare surgical outcome in mesial temporal lobe epilepsy (MTLE) patients with unilateral hippocampal sclerosis (MTLE-HS) who had or did not have preoperative video-electroencephalographic monitoring (VEEG). METHODS:A prospective study was undertaken with 166 consecutive pharmacoresistant unilateral MTLE-...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/epi.13977

    authors: Alvim MKM,Morita ME,Yasuda CL,Damasceno BP,Lopes TM,Coan AC,Ghizoni E,Tedeschi H,Cendes F

    更新日期:2018-02-01 00:00:00

  • Magnetic resonance imaging in animal models of epilepsy-noninvasive detection of structural alterations.

    abstract::Small animal magnetic resonance imaging (MRI) has opened a window through which brain abnormalities can be observed over time in rodents noninvasively. We review MRI studies done during epileptogenesis triggered by status epilepticus in rat. Most of these studies have used quantitative T2, diffusion, and/or volumetric...

    journal_title:Epilepsia

    pub_type: 杂志文章,评审

    doi:10.1111/j.1528-1167.2007.01236.x

    authors: Gröhn O,Pitkänen A

    更新日期:2007-01-01 00:00:00

  • Severe burns as a consequence of seizures in patients with epilepsy.

    abstract::We report 10 seizure-related thermal injuries severe enough to require hospitalization in patients with epilepsy. Eight of the ten incidents were with patients who had had seizures with impaired consciousness two or more times a month. This suggests that seizure frequency is a risk factor and implies the importance of...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1157.1992.tb02290.x

    authors: Spitz MC

    更新日期:1992-01-01 00:00:00

  • The ictal bradycardia syndrome: localization and lateralization.

    abstract:PURPOSE:Previous studies have established the importance of the insular cortex and temporal lobe in cardiovascular autonomic modulation. Some investigators, based on the results of cortical stimulation response, functional imaging, EEG recordings of seizures, and lesional studies, have suggested that cardiac sympatheti...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1167.2006.00509.x

    authors: Britton JW,Ghearing GR,Benarroch EE,Cascino GD

    更新日期:2006-04-01 00:00:00