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phenytoin with epilepsi

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https://www.readbyqxmd.com/read/29680205/comparative-risk-of-major-congenital-malformations-with-eight-different-antiepileptic-drugs-a-prospective-cohort-study-of-the-eurap-registry
#1
Torbjörn Tomson, Dina Battino, Erminio Bonizzoni, John Craig, Dick Lindhout, Emilio Perucca, Anne Sabers, Sanjeev V Thomas, Frank Vajda
BACKGROUND: Evidence for the comparative teratogenic risk of antiepileptic drugs is insufficient, particularly in relation to the dosage used. Therefore, we aimed to compare the occurrence of major congenital malformations following prenatal exposure to the eight most commonly used antiepileptic drugs in monotherapy. METHODS: We did a longitudinal, prospective cohort study based on the EURAP international registry. We included data from pregnancies in women who were exposed to antiepileptic drug monotherapy at conception, prospectively identified from 42 countries contributing to EURAP...
April 18, 2018: Lancet Neurology
https://www.readbyqxmd.com/read/29644157/persistent-bradycardia-with-the-long-term-use-of-phenytoin-and-oxycodone-first-case-report
#2
Intekhab Askari Syed, Aaron R Kuzel, Muhammad Uzair Lodhi, Waliul Chowdhury, Umar Rahim, Mustafa Rahim
Phenytoin is a medication that is used primarily in the treatment of epilepsy as well as generalized tonic-clonic seizures and status epilepticus. Phenytoin is also considered a class IB antiarrhythmic medication by shortening the duration of the action potential and increasing myocardial conduction. The neurologic adverse effects of phenytoin are well-documented and include altered mental status, ataxia, and nystagmus. Some adverse cardiac manifestations have also been reported, including arrhythmias, hypotension, and respiratory arrest...
February 8, 2018: Curēus
https://www.readbyqxmd.com/read/29625812/scn2a-mutation-in-an-infant-presenting-with-migrating-focal-seizures-and-infantile-spasm-responsive-to-a-ketogenic-diet
#3
Da-Jyun Su, Jyh-Feng Lu, Li-Ju Lin, Jao-Shwann Liang, Kun-Long Hung
SCN2A mutations have been identified in various encephalopathy phenotypes, ranging from benign familial neonatal-infantile seizure (BFNIS) to more severe forms of epileptic encephalopathy such as Ohtahara syndrome or epilepsy of infancy with migrating focal seizure (EIMFS). Thus far, no particularly effective treatment is available for severe epileptic encephalopathy caused by SCN2A mutations in children. We present the case of a boy who developed seizures on the third day of life and received a diagnosis of EIMFS based on his clinical presentations and electroencephalography reports...
April 3, 2018: Brain & Development
https://www.readbyqxmd.com/read/29610167/-hla-a-31-01-and-oxcarbazepine-induced-dress-in-a-patient-with-seizures-and-complete-dcx-deletion
#4
Hyun Kim, Laura Chadwick, Yasir Alzaidi, Jonathan Picker, Annapurna Poduri, Shannon Manzi
Oxcarbazepine is an antiepileptic drug (AED) commonly used as a first-line treatment option for focal epilepsy. Several AEDs, including carbamazepine, oxcarbazepine, and phenytoin are associated with various delayed-hypersensitivity reactions such as drug reaction with eosinophilia and systemic symptoms, Stevens-Johnson syndrome, or toxic epidermal necrolysis. The Food and Drug Administration-approved label for oxcarbazepine currently presents information regarding a pharmacogenomic association with the HLA antigen allele HLA-B*15:02 and hypersensitivity reactions in certain ancestry groups with a high incidence of this allele...
April 2018: Pediatrics
https://www.readbyqxmd.com/read/29588957/dress-syndrome-a-case-of-cross-reactivity-with-lacosamide
#5
Man Kei Fong, Bun Sheng
A 42-year-old patient with epilepsy was admitted to the hospital for fever and generalized skin rash. He has known allergy to phenytoin. Valproate was started in 2012, but failed to control his seizure despite gradual increase in dosage. Phenobarbitone was added 16 days before admission and was stopped on admission. He was treated with beta-lactam antibiotics. The rash subsided gradually after the cessation of phenobarbitone. Lacosamide was subsequently added for seizure control. Unfortunately, he developed drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome soon after introduction of lacosamide that required the use of systemic steroid for acute hepatitis...
June 2017: Epilepsia Open
https://www.readbyqxmd.com/read/29571152/comparative-efficacy-of-unique-antiepileptic-drug-regimens-in-focal-epilepsy-an-exploratory-study
#6
Alexander W Legge, Kamil Detyniecki, Asif Javed, Lawrence J Hirsch, Kenneth Kato, Richard Buchsbaum, Baibing Chen, Hyunmi Choi
OBJECTIVE: To compare efficacy of unique antiepileptic drug (AED) polytherapy regimens among patients with focal epilepsy. METHODS: From a longitudinal study of AED treatment, we identified patients with active focal epilepsy who had attempted at least two unique AED regimens (mono-, duo-, or tri-therapy). Efficacy was defined as the presence of at least one six-month period of continuous seizure freedom during exposure to a regimen. To control for individual variations in response and epilepsy severity, we used within-patient comparison approaches, in which we: 1) compared head-to-head unique regimens tried within the same patients; 2) compared one regimen versus aggregate of other regimens attempted in that patient; and 3) compared aggregated monotherapy versus polytherapy regimens...
March 10, 2018: Epilepsy Research
https://www.readbyqxmd.com/read/29565514/correlation-between-nurr1-expression-and-drug-resistance-in-the-brain-of-rats-with-epilepsy
#7
H-Y Li, F Liu, H-R Wang
OBJECTIVE: To investigate the correlation between nuclear receptor related 1 (Nurr1) expression and drug resistance in the brain of rats with epilepsy. MATERIALS AND METHODS: A total of 60 adult male Sprague-Dawley rats were selected, and the animal model of epilepsy was established by electrical stimulation. These rats were randomly divided into the control group and the drug-resistant group. The model of drug-resistant epilepsy was screened with phenytoin (PHT) and phenobarbital (PB); the hippocampus and temporal lobe cortex tissues were isolated from rats; the messenger ribonucleic acid (mRNA) and protein levels of Nurr1 in the hippocampus and cortex tissues of the two groups of rats were detected by reverse transcription polymerase chain reaction (RT-PCR), Western blotting and immunohistochemistry, respectively...
March 2018: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29547827/pharmacological-characterization-of-the-cannabinoid-receptor-2-agonist-%C3%AE-caryophyllene-on-seizure-models-in-mice
#8
Jana Tchekalarova, Keylla da Conceição Machado, Antonio Luiz Gomes Júnior, Ana Amélia de Carvalho Melo Cavalcante, Albena Momchilova, Rumyana Tzoneva
PURPOSE: Activation of CB1 receptors, produces anticonvulsant effect accompanied by memory disturbance both in animal seizure tests and in patients with epilepsy. Few reports considered the role of CB2 receptor on seizure susceptibility and cognitive functions. The aim of the present study was to explore the effect of a selective CB2 receptor agonist β-caryophyllene (BCP) in models of seizures and cognition in mice. METHODS: Dose-dependent effects of BCP was studied in maximal electroshock seizure (MES) test, subcutaneous pentylenetetrazole (scPTZ) test and Morris water maze test...
March 12, 2018: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/29498493/effect-of-antiepileptic-drug-comedication-on-lamotrigine-concentrations
#9
Mila Lovrić, Ivana Čajić, Željka Petelin Gadže, Iva Klarica Domjanović, Nada Božina
AIM: To estimate the effect size of concomitant antiepileptic therapy on the concentrations of lamotrigine, a drug often prescribed in combination with other antiepileptic drugs (AED), which can act as enzyme inducers or inhibitors. METHODS: A total of 304 patients with epilepsy, aged 18-70 years, were divided into a lamotrigine monotherapy group and groups receiving lamotrigine with AEDs that act as enzyme inducers, enzyme inhibitors, or both. We compared lamotrigine monotherapy serum concentrations with those where lamotrigine was administered with a metabolic inhibitor valproate, metabolic inducers carbamazepine, oxcarbazepine, phenobarbital, phenytoin, or topiramate, and both an inducer and an inhibitor...
February 28, 2018: Croatian Medical Journal
https://www.readbyqxmd.com/read/29486142/antiepileptic-drug-titration-and-related-health-care-resource-use-and-costs
#10
Jesse Fishman, Linda Kalilani, Yan Song, Elyse Swallow, Imane Wild
BACKGROUND: Unexpected breakthrough seizures resulting from suboptimal antiepileptic drug (AED) dosing during the titration period, as well as adverse events resulting from rapid AED titration, may influence the titration schedule and significantly increase health care resource use (HRU) and health care costs. OBJECTIVE: To assess the relationship between AEDs, HRU, and costs during AED titration and maintenance. METHODS: Practicing neurologists were recruited from a nationwide panel to provide up to 3 patient records each for this retrospective medical chart review...
February 27, 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29477837/a-survey-of-antiepileptic-drug-responses-identifies-drugs-with-potential-efficacy-for-seizure-control-in-wolf-hirschhorn-syndrome
#11
Karen S Ho, Leah M Markham, Hope Twede, Amanda Lortz, Lenora M Olson, Xiaoming Sheng, Cindy Weng, E Robert Wassman, Tara Newcomb, E Robert Wassman, John C Carey, Agatino Battaglia
Seizures are present in over 90% of infants and children with Wolf-Hirschhorn syndrome (WHS). When present, they significantly affect quality of life. The goal of this study was to use caregiver reports to describe the comparative efficacies of commonly used antiepileptic medications in a large population of individuals with WHS. A web-based, confidential caregiver survey was developed to capture seizure semiology and a chronologic record of seizure treatments as well as responses to each treatment. Adverse events for each drug were also cataloged...
February 22, 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29466837/mutations-in-scn3a-cause-early-infantile-epileptic-encephalopathy
#12
Tariq Zaman, Ingo Helbig, Ivana Babić Božović, Suzanne D DeBrosse, A Christina Bergqvist, Kimberly Wallis, Livija Medne, Aleš Maver, Borut Peterlin, Katherine L Helbig, Xiaohong Zhang, Ethan M Goldberg
OBJECTIVE: Voltage-gated sodium (Na+ ) channels underlie action potential generation and propagation and hence are central to the regulation of excitability in the nervous system. Mutations in the genes SCN1A, SCN2A, and SCN8A, encoding the Na+ channel pore-forming (α) subunits Nav1.1, 1.2, and 1.6, respectively, and SCN1B, encoding the accessory subunit β1 , are established causes of genetic epilepsies. SCN3A, encoding Nav1.3, is known to be highly expressed in brain, but has not previously been linked to early infantile epileptic encephalopathy...
February 21, 2018: Annals of Neurology
https://www.readbyqxmd.com/read/29464573/intrinsic-inflammation-is-a-potential-anti-epileptogenic-target-in-the-organotypic-hippocampal-slice-model
#13
Seon-Ah Chong, Silvia Balosso, Catherine Vandenplas, Gregory Szczesny, Etienne Hanon, Kasper Claes, Xavier Van Damme, Bénédicte Danis, Jonathan Van Eyll, Christian Wolff, Annamaria Vezzani, Rafal M Kaminski, Isabelle Niespodziany
Understanding the mechanisms of epileptogenesis is essential to develop novel drugs that could prevent or modify the disease. Neuroinflammation has been proposed as a promising target for therapeutic interventions to inhibit the epileptogenic process that evolves from traumatic brain injury. However, it remains unclear whether cytokine-related pathways, particularly TNFα signaling, have a critical role in the development of epilepsy. In this study, we investigated the role of innate inflammation in an in vitro model of post-traumatic epileptogenesis...
February 20, 2018: Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics
https://www.readbyqxmd.com/read/29445430/seizure-prophylaxis-in-the-immediate-post-hemorrhagic-period-in-patients-with-aneurysmal-subarachnoid-hemorrhage
#14
Thomas V Kodankandath, Salman Farooq, Wled Wazni, John-Andrew Cox, Christopher Southwood, Gregory Rozansky, Vijay Johnson, John R Lynch
Introduction: Seizures are a well-known complication of aneurysmal subarachnoid hemorrhage (aSAH) and occur most commonly in the immediate posthemorrhagic period. Most commonly used antiepileptic drugs (AEDs) for seizure prophylaxis in aSAH include phenytoin and levetiracetam. There is no reliable data available on the safety and efficacy of restricting AED prophylaxis only till the aneurysm is secured. Methods: We retrospectively chart reviewed patients admitted to our neurosciences intensive care unit (NICU) with aSAH during the past two years...
December 2017: Journal of Vascular and Interventional Neurology
https://www.readbyqxmd.com/read/29437004/therapeutic-drug-monitoring-of-phenytoin-by-simple-rapid-accurate-highly-sensitive-and-novel-method-and-its-clinical-applications
#15
Abdul Sami Shaikh, Ruichen Guo
BACKGROUND: Phenytoin has very challenging pharmacokinetic properties. To prevent its toxicity and ensure efficacy, continuous therapeutic monitoring is required. It is hard to get a simple, accurate, rapid, easily available, economical and highly sensitive assay in one method for therapeutic monitoring of phenytoin. OBJECTIVE: The present study is directed towards establishing and validating a more simple, rapid, an accurate, highly sensitive, novel and environment friendly liquid chromatography/mass spectrometry (LC/MS) method for offering rapid and reliable TDM results of phenytoin in epileptic patients to physicians and clinicians for making immediate and rational decision...
February 9, 2018: Current Pharmaceutical Biotechnology
https://www.readbyqxmd.com/read/29427835/phenytoin-related-ataxia-in-patients-with-epilepsy-clinical-and-radiological-characteristics
#16
Priya D Shanmugarajah, Nigel Hoggard, Daniel P Aeschlimann, Pascale C Aeschlimann, Gary J Dennis, Stephen J Howell, Markus Reuber, Richard A Grünewald, Marios Hadjivassiliou
PURPOSE: Phenytoin is an effective anticonvulsant for focal epilepsy. Its use can be associated with long-term adverse effects including cerebellar ataxia. Whilst phenytoin is toxic to Purkinje cells in vitro; the clinical and radiological phenotype and mechanism of cerebellar degeneration in vivo remain unclear. We describe the prevalence, clinical and radiological characteristics of phenytoin-related ataxia. METHODS: Patients with epilepsy receiving treatment with phenytoin were recruited from the Epilepsy clinics at Royal Hallamshire Hospital, Sheffield, UK...
February 2, 2018: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/29414565/current-state-of-the-union-of-epilepsy-care-in-the-united-states-antiepileptic-drugs-an-introduction-to-the-connectors-project
#17
Joseph I Sirven, Patricia O Shafer, Linda Kalilani, Imane Wild, Jesse Fishman, Steve Owens
PURPOSE: How antiepileptic drugs (AEDs) are used in the United States (US) is one proxy public health indicator for the current state of epilepsy management. The use of phenytoin, other older AEDs, and newer AEDs may act as an indicator for the quality of epilepsy practice in addition to the current American Academy of Neurology quality measures. Data on AED used by states and populations can help identify which public health interventions are necessary to improve the status of epilepsy care...
February 1, 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29389596/flavonoid-compounds-as-reversing-agents-of-the-p-glycoprotein-mediated-multidrug-resistance-an-in-vitro-evaluation-with-focus-on-antiepileptic-drugs
#18
Ana Ferreira, Márcio Rodrigues, Ana Fortuna, Amílcar Falcão, Gilberto Alves
The pharmacoresistance to antiepileptic drugs (AEDs) remains a major unsolved therapeutic need. The overexpression of multidrug transporters, as the P-glycoprotein (P-gp), at the level of the blood-brain barrier of epileptic patients has been suggested as a key mechanism underlying the refractory epilepsy. Thus, efforts have been made to search for therapeutically useful P-gp inhibitors. Herein, the strategy of flavonoid/AED combined therapy was exploited as a possible approach to overcome the P-gp-mediated pharmacoresistance...
January 2018: Food Research International
https://www.readbyqxmd.com/read/29366689/in-vivo-study-of-teratogenic-and-anticonvulsant-effects-of-antiepileptics-drugs-in-zebrafish-embryo-and-larvae
#19
C S Martinez, D A Feas, M Siri, D E Igartúa, N S Chiaramoni, S Del V Alonso, M J Prieto
Epilepsy is a neurological disorder treated with antiepileptic drugs (AEDs). Since AEDs are administered in women in childbearing age, it is critical to study if drugs are capable of inducing developmental toxicity. Along the bibliography available, there is no research comparing teratogenicity and anticonvulsant effect within the same study. In the present study, we evaluated the teratogenic and anticonvulsant effects of six different AEDs: carbamazepine, levetiracetam, lamotrigine, phenobarbital, phenytoin and valproic acid...
March 2018: Neurotoxicology and Teratology
https://www.readbyqxmd.com/read/29363050/effect-of-age-related-factors-on-the-pharmacokinetics-of-lamotrigine-and-potential-implications-for-dose-optimisation-in-epilepsy-patients
#20
Sven C van Dijkman, Nico C B de Jager, Willem M Rauwé, Meindert Danhof, Oscar Della Pasqua
BACKGROUND AND AIMS: In this study, we evaluate the performance of allometric concepts to predict the implications of age and size on the pharmacokinetics of lamotrigine, and assess the dose rationale across different age groups from 0.2 to 91 years. METHODS: An allometrically scaled pharmacokinetic model was developed using adolescent and adult data, taking into account the effect of comedications. Model parameters were then used to extrapolate lamotrigine pharmacokinetics to older adults (> 65 years), children (4-12 years) and infants and toddlers (0...
January 23, 2018: Clinical Pharmacokinetics
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