Abstract:
PURPOSE:The standard practice of switching patients to carbamazepine (CBZ) involves initiating a low dose and raising it by small increments until the desired dose is reached, to avoid intolerable adverse effects (AE). In a pilot study, a protocol using single-dose kinetic studies was developed to switch patients to CBZ through rapid-dose increments and to manage concurrent rapid taper of the previous antiepileptic drugs (AEDs) without causing AE. The purpose of this prospective study was (a) to reassess whether a rapid switchover to CBZ could be done with minimal or no AE and without causing an increase in seizures; (b) to determine whether the maintenance dose of CBZ predicted at the time of the single-dose kinetic study can yield the desired concentration at steady state (Css); and (c) to determine the degree to which the calculated maintenance dose of CBZ will need to be adjusted after the previous AED has been discontinued for a four-week period. METHODS:Twenty-five patients taking phenytoin (PHT) and/ or phenobarbital (PB) and/or primidone (PRM) underwent a rapid switchover to CBZ following a 10 mg/kg single-dose kinetic study (day 1) which allowed calculation of a maintenance dose necessary to yield a mean Css of 10.2 (+/-2.2) mg/l. On day 2, patients received a CBZ dose equivalent to 10 mg/kg + 200 mg; thereafter, they underwent daily dose increments of 200 mg until the calculated maintenance dose was reached. Dose increments were modified in the case of AE. Concurrent tapering of the previous AED was started as of day 1: PHT by 100 mg/day, while PB and PRM were stopped on day 1; PB was restarted before patients were to be discharged from the hospital if a PB serum concentration above 10 mg/l was identified at that time. Pharmacokinetic data and occurrence of AE were compared between the two groups at the time of the single-dose kinetic study, at the completion of the switchover to CBZ, and 4 weeks after discontinuation of the previous AED. RESULTS:All patients completed the switchover to CBZ within a mean time period of 6 days (+/-2), reaching a mean maintenance dose of 1,639 mg/day (+/-370) which yielded a mean Css of 11.3 (+/-3.2) mg/l. The maintenance dose had to be lowered by 20.4% (+/-8.3) in 59% of patients within the four-week period following discontinuation of at least one of the previous AEDs. None of the patients experienced an increase in seizure frequency relative to baseline. Fifteen (60%) patients had no AE; five (20%) experienced AE of mild severity. AE rated as moderately severe (n = 4) or severe (n = 1) occurred in patients with a static encephalopathy (p = 0.02, Fisher's exact test) and among patients > or =55 years (p = 0.017, Fisher's exact test). CONCLUSIONS:A rapid switch-over to CBZ from PHT, PB, or PRM can be carried out safely with no, or minimal, AE in young adults, unless they suffer from static encephalopathy.
journal_name
Epilepsiajournal_title
Epilepsiaauthors
Kanner AM,Bourgeois BF,Hasegawa H,Hutson Pdoi
10.1111/j.1528-1157.1998.tb01358.xsubject
Has Abstractpub_date
1998-02-01 00:00:00pages
194-200issue
2eissn
0013-9580issn
1528-1167journal_volume
39pub_type
杂志文章相关文献
EPILEPSIA文献大全abstract:BACKGROUND:The incidence of status epilepticus (SE) in Asian children, including Japanese, has not been reported. METHODS:In 2003, we performed an epidemiological study of SE on Japanese children (31 days or older to <15 years of age) in Okayama City by ascertaining all lifetime first episodes of SE. RESULTS:Thirty-s...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1167.2007.01106.x
更新日期:2007-06-01 00:00:00
abstract:PURPOSE:Prior studies have given conflicting data concerning the association of benign rolandic epilepsy of childhood (BREC) and migraine but were limited by lack of sensitive, diagnostic criteria for childhood migraine. By using revised International Headache Society (IHS-R) criteria, we compared the prevalence of mig...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1167.2006.00639.x
更新日期:2006-10-01 00:00:00
abstract:PURPOSE: Vagus nerve stimulation (VNS) provides partial relief of medically refractory partial seizures in a subset of patients. The optimal pattern of stimulation and the mechanism of the antiseizure effects are uncertain. Establishing the efficacy of VNS in an animal model of epilepsy would provide an experimental p...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1167.2012.03646.x
更新日期:2012-11-01 00:00:00
abstract::Nonconvulsive status epilepticus may be subdivided into generalized (absence) status and complex partial status. The latter is regarded as a rarity, whereas the former constitutes the dominant part of the hitherto reported cases. We report 10 consecutive cases of adult patients with nonconvulsive status epilepticus, a...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1157.1986.tb03540.x
更新日期:1986-05-01 00:00:00
abstract::The effects of seizures on the hypocretin/orexin system have not yet been investigated in epileptic patients. The present study aimed to assay hypocretin-1 in the cerebrospinal fluid (CSF) of patients after generalized tonic-clonic (GTC) seizures. Study groups consisted of 21 patients after GTC seizures and 19 control...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1167.2008.01990.x
更新日期:2009-06-01 00:00:00
abstract:OBJECTIVE:Epilepsy is common in individuals with mutations in POLG, the gene encoding the catalytic subunit of the mitochondrial DNA polymerase gamma. Early recognition and aggressive seizure management are crucial for patient survival. Disruption of the blood-brain barrier (BBB) is implicated in various neurological d...
journal_title:Epilepsia
pub_type: 杂志文章,多中心研究
doi:10.1111/epi.14459
更新日期:2018-08-01 00:00:00
abstract:PURPOSE:Intracerebral vascular malformations including cavernous angiomas (CAs) and arteriovenous malformations (AVMs) are an important cause of chronic pharmacoresistant epilepsies. Little is known about the pathogenetic basis of epilepsy in patients with vascular malformations. Intracerebral deposits of iron-containi...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1167.2012.03405.x
更新日期:2012-03-01 00:00:00
abstract:PURPOSE:To determine the incidence, duration, risk factors for, and clinical correlates of postictal generalized electroencephalography (EEG) suppression (PGES), and to further delineate the significance of PGES in the pathogenesis of sudden unexpected death in epilepsy (SUDEP). METHODS:We retrospectively reviewed the...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/epi.12094
更新日期:2013-05-01 00:00:00
abstract::This chapter covers the syndromes of benign epilepsy with centrotemporal spikes (BECTS), nonlesional focal epilepsy in otherwise normal children (NLFN), and the genetic generalized epilepsies. BECTS is an epilepsy syndrome that always enters terminal remission before the general age of a planned transition of adolesce...
journal_title:Epilepsia
pub_type: 杂志文章,评审
doi:10.1111/epi.12706
更新日期:2014-08-01 00:00:00
abstract:OBJECTIVE:Depression is a common comorbidity of epilepsy, and its timely identification in persons with epilepsy is essential. The use of screening tools to detect depression is common in epilepsy, but some scales in current use have not been validated using a gold standard in this population. The present study aims to...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/epi.12754
更新日期:2014-10-01 00:00:00
abstract::Cognitive impairment is the most common comorbidity in children with epilepsy, but its pathophysiology and predisposing conditions remain unknown. Clinical epilepsy characteristics are not conclusive in determining cognitive outcome. Because many children with epilepsy do not have macrostructural magnetic resonance im...
journal_title:Epilepsia
pub_type: 杂志文章,评审
doi:10.1111/j.1528-1167.2012.03624.x
更新日期:2012-10-01 00:00:00
abstract::The first description of epileptic encephalopathies dates back to Dr. West who, in 1857, described the syndrome that took his name. In addition to West syndrome, in the last century other epileptic syndromes entered into the chapter of epileptic encephalopathies. Henry Gastaut has the virtue of having created the mode...
journal_title:Epilepsia
pub_type: 历史文章,杂志文章,评审
doi:10.1111/epi.12416
更新日期:2013-11-01 00:00:00
abstract::Early in these proceedings, the origin of the three terms in the title, "idiopathic generalized epilepsy," is discussed with respect to their significance over time, and typical misunderstandings. In the mid-20th century, a rather chaotic use of a multitude of often loosely defined terms had developed, which increasin...
journal_title:Epilepsia
pub_type: 历史文章,杂志文章
doi:10.1111/j.1528-1167.2005.00308.x
更新日期:2005-01-01 00:00:00
abstract::Hyperthermia was induced in mature rats by immersing them in 20 cm of 45 degrees C water for 4 min. Rats were made hyperthermic once every 4 days for six exposures. A significant number had at least one convulsion by the third exposure. During the seventh exposure, 2 weeks after the sixth exposure, twice as many rats ...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1157.1984.tb04192.x
更新日期:1984-06-01 00:00:00
abstract:OBJECTIVE:Self-management challenges facing adults with epilepsy include limited understanding of the condition and treatment, associated psychosocial issues, and lack of community integration. Self-management interventions improve patients' medical, life role, and emotional management. Previous interventions, develope...
journal_title:Epilepsia
pub_type: 杂志文章,随机对照试验
doi:10.1111/epi.13052
更新日期:2015-08-01 00:00:00
abstract:PURPOSE:Focal cortical dysplasia type IIb (FCD IIb) lesions are highly epileptogenic and frequently cause pharmacoresistant epilepsy. Complete surgical resection leads to seizure freedom in most cases. However, the term "complete" resection is controversial with regard to the necessity of performing resections of the s...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1167.2011.03158.x
更新日期:2011-08-01 00:00:00
abstract::Epilepsy is a disease of complex etiology, and multiple molecular mechanisms contribute to its development. Temporal lobe epilepsy (TLE) may result from an initial precipitating event such as hypoxia, head injury, or prolonged seizure (i.e., status epilepticus [SE]), that is followed by a latent period of months to ye...
journal_title:Epilepsia
pub_type: 杂志文章,评审
doi:10.1111/epi.12036
更新日期:2012-12-01 00:00:00
abstract:AIM:Dedicated magnetic resonance imaging (MRI) protocol can diagnose epileptogenic abnormalities in patients with intractable epilepsy. However, it is not sufficiently sensitive to detect small calcified lesions that may result from infections, tumors, or vascular malformations. This study aims to study the impact of t...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1167.2008.01882.x
更新日期:2009-06-01 00:00:00
abstract::The teratological effect of nicotine has been studied during different trimesters of pregnancy. Three groups of pregnant albino Swiss mice were used for each trimester. The daily doses of nicotine base used were equivalent to 10 (900 micrograms/kg), 20 (1,800 micrograms/kg), or 30 (2,700 micrograms/kg) cigarettes. The...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1157.1985.tb05708.x
更新日期:1985-11-01 00:00:00
abstract::Nuclear magnetic resonance is a noninvasive technique of imaging the brain using signals produced by magnetic fields and radiowaves. Sixteen patients with refractory temporal lobe epilepsy (TLE) had magnetic resonance imaging (MRI) during investigation for possible surgical management. These images plus those of 10 no...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1157.1985.tb05691.x
更新日期:1985-11-01 00:00:00
abstract::The Commission on Classification and Terminology and the Commission on Epidemiology of the International League Against Epilepsy (ILAE) have charged a Task Force to revise concepts, definition, and classification of status epilepticus (SE). The proposed new definition of SE is as follows: Status epilepticus is a condi...
journal_title:Epilepsia
pub_type: 历史文章,杂志文章,评审
doi:10.1111/epi.13121
更新日期:2015-10-01 00:00:00
abstract::Over 100 years ago, on the 27th of January 1881, Fyodor Mikhailovitch Dostoevsky died. Since that time, many biographies, monographs, memoirs, and, to a lesser extent, articles in the medical literature have discussed the fact that Dostoevsky was a patient with epilepsy. An attempt is made here to integrate the detail...
journal_title:Epilepsia
pub_type: 传,历史文章,杂志文章
doi:10.1111/j.1528-1157.1983.tb04628.x
更新日期:1983-12-01 00:00:00
abstract:OBJECTIVE:Mutations involving the cyclin-dependent kinase-like 5 (CDKL5) gene cause an early onset epileptic encephalopathy (EE) with severe neurologic impairment and a skewed 12:1 female-to-male ratio. To date, 18 mutations have been described in boys. We analyzed our cohort of boys with early onset EE to assess the d...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/epi.12803
更新日期:2014-11-01 00:00:00
abstract::The identification and correction of adverse physiological changes that lead to seizures in children can improve the effectiveness of current therapeutic practices in epilepsy. It is proposed that various circadian rhythms (respiration, hormones, water balance, electrolytes, intracranial pressure, blood pressure), met...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1157.1980.tb04090.x
更新日期:1980-08-01 00:00:00
abstract:OBJECTIVE:Pathogenic variants of KCNQ2, which encode a potassium channel subunit, cause either benign (familial) neonatal epilepsy-B(F)NE)-or KCNQ2 encephalopathy (KCNQ2 DEE). We examined the characteristics of KCNQ2 variants. METHODS:KCNQ2 pathogenic variants were collected from in-house data and two large disease da...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/epi.16314
更新日期:2019-09-01 00:00:00
abstract:PURPOSE:To describe the correlation between visual field loss and the duration, dosage, and total amount of vigabatrin (VGB) medication in a group of patients with epilepsy. Co-medication of antiepileptic drugs (AEDs) and compliance were also studied. METHODS:Ninety-two patients (53 male and 39 female) taking VGB medi...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1046/j.1528-1157.2001.15000.x
更新日期:2001-02-01 00:00:00
abstract::Electroencephalography (EEG)-the direct recording of the electrical activity of populations of neurons-is a tremendously important tool for diagnosing, treating, and researching epilepsy. Although standard procedures for recording and analyzing human EEG exist and are broadly accepted, there are no such standards for ...
journal_title:Epilepsia
pub_type: 杂志文章,评审
doi:10.1111/epi.13909
更新日期:2017-11-01 00:00:00
abstract:PURPOSE:Epileptic seizures are associated with a dysregulation of electrical brain activity on many different spatial scales. To better understand the dynamics of epileptic seizures, that is, how the seizures initiate, propagate, and terminate, it is important to consider changes of electrical brain activity on differe...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1167.2012.03588.x
更新日期:2012-09-01 00:00:00
abstract::Presently available noninvasive methods correctly localize epileptogenic regions in only approximately 50% of patients with frontal lobe epilepsy (FLE). Earlier studies have shown that temporal lobe epileptogenic regions may be identified readily by positron emission tomography (PET) measurements of regional benzodiaz...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1157.1995.tb01066.x
更新日期:1995-12-01 00:00:00
abstract:PURPOSE:To evaluate the potential pharmacokinetic interactions between topiramate (TPM) and phenytoin (PHT) in patients with epilepsy by studying their pharmacokinetics (PK) after monotherapy and concomitant TPM/PHT treatment. METHODS:Twelve patients with epilepsy stabilized on PHT monotherapy were enrolled in this st...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1046/j.1528-1157.2002.41701.x
更新日期:2002-07-01 00:00:00