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Valproate and clonazepam

Roberto Michelucci, Elena Pasini, Patrizia Riguzzi, Eva Andermann, Reetta Kälviäinen, Pierre Genton
Generalized motor seizures, usually tonic-clonic, tonic-vibratory, myoclonic or clonic, and stimulus-sensitive/action myoclonus are typical features of progressive myoclonus epilepsies (PMEs). Despite the introduction of many anticonvulsants, the treatment of these symptoms, particularly myoclonus, remains challenging, due to the incomplete and often transitory effects of most drugs. Moreover, treatment is only symptomatic, since therapy targeting the underlying aetiology for these genetic conditions is in its infancy...
September 1, 2016: Epileptic Disorders: International Epilepsy Journal with Videotape
Choong Yi Fong, Nurmaira Hashim, Chin Seng Gan, Tak Kuan Chow, Chee Geap Tay
BACKGROUND: Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare and potentially life-threatening acute drug-induced hypersensitivity reaction. Antiepileptic drugs (AEDs) predominantly aromatic AEDs are commonly reported in DRESS. To date there are no reports of sulthiame AED causing DRESS syndrome. METHOD: We report a 10-year-old girl of Indian descent with AED resistant epilepsy on maintenance sodium valproate and clonazepam. Sulthiame AED was initiated to try to improve her seizure control...
November 2016: European Journal of Paediatric Neurology: EJPN
Edward P Chronicle, Wim M Mulleners
No abstract text is available yet for this article.
2016: Cochrane Database of Systematic Reviews
Edward C Lauterbach
Anxiety is common in the Mild Cognitive Impairment (MCI) stage of Alzheimer's disease (AD) and the pre-motor stages of Parkinson's disease (PD). A concomitant and possible cause of this anxiety is microglial activation, also considered a key promoter of neurodegeneration in MCI and early PD via inflammatory mechanisms and the generation of degenerative proinflammatory cytokines. Psychiatric disorders, prevalent in AD and PD, are often treated with psychiatric drugs (psychotropics), raising the question of whether psychotropics might therapeutically affect microglial activation, MCI, and PD...
2016: American Journal of Neurodegenerative Disease
Ariel Levy, Robert Chen
Treatment of myoclonus requires an understanding of the physiopathology of the condition. The first step in treatment is to determine if there is an epileptic component to the myoclonus and treat accordingly. Secondly, a review of medications (e.g., opiates) and comorbidities (e.g., hepatic or renal failure) is required to establish the possibility of iatrogenic and reversible conditions. Once those are eliminated, delineation between cortical, cortico-subcortical, subcortical, brainstem, and spinal generators can determine the first-line treatment...
May 2016: Current Treatment Options in Neurology
Orakwue A Molokwu, Birinus A Ezeala-Adikaibe, Ikenna O Onwuekwe
BACKGROUND: Levetiracetam-induced rage is a rare neurobehavioral adverse effect of levetiracetam that is characterized by seething rage, uncontrollable anger, fits of fury, depression, violence, and suicidal tendencies. It occurs more in patients with prior mood or psychotic disturbances. No such case has been reported in Nigeria. METHOD: We report two cases of levetiracetam-induced rage. The first patient was a 29-year-old male with a 14-year history of intractable posttraumatic epilepsy...
2015: Epilepsy & Behavior Case Reports
Monika Popławska, Dorota Wróblewska, Kinga K Borowicz
BACKGROUND: The incidence rate of depression among patients with epilepsy is relatively high. The basis of proper therapy is knowledge of drug interactions, which may enable to maximize therapeutic effects and minimize undesired effects of the combined treatment. The purpose of this study was to evaluate the influence of reboxetine, a selective norepinephrine reuptake inhibitor, on the seizure threshold and anticonvulsant effects of four classic antiepileptic drugs: valproate, phenobarbital, ethosuximide, and clonazepam...
December 2015: Pharmacological Reports: PR
Estevo Santamarina, María Sueiras, Rosa M Lidón, Lorena Guzmán, Jordi Bañeras, Montserrat González, Manuel Toledo, Xavier Salas-Puig
UNLABELLED: Proper treatment of hypoxic myoclonic status is not clearly determined. Induced hypothermia is improving prognosis and a more aggressive treatment might be beneficial in some patients. Among the new options of antiepileptic drugs, perampanel (PER) is a drug with a novel mechanism, and it might be a promising drug for myoclonic status or as an antimyoclonic drug. We describe the use of PER in one patient with hypoxic super-refractory myoclonic status. DESCRIPTION: A 51-year-old patient presented after an out-of-hospital cardiac arrest due to an acute myocardial infarction...
2015: Epilepsy & Behavior Case Reports
Sayaka Suzuki, Kaori Sassa, Yuichi Abe, Hideo Yamanouchi
We report a 4-year-old boy with generalized seizures with abrupt falling and unresponsive staring provoked by somatosensory stimuli of the face. Ictal manifestation comprised a sudden fall immediately after wiping the face, followed by unresponsive staring for around 10 seconds, during which time the video-EEG recorded paroxysmal 3-Hz diffuse spike-wave complexes, which were followed by high-voltage 3.5 to 4-Hz delta wave discharges, predominantly appearing in the bilateral frontal areas. Seizures were not controlled by clonazepam, valproate or levetiracetam, but were successfully treated with lamotrigine added to valproate...
September 2015: Epileptic Disorders: International Epilepsy Journal with Videotape
Xiu-Yu Shi, Yuko Tomonoh, Wen-Ze Wang, Atsushi Ishii, Norimichi Higurashi, Hirokazu Kurahashi, Sunao Kaneko, Shinichi Hirose
OBJECTIVE: Evaluation of the efficacy of antiepileptic drugs (AEDs) used in the treatment of Dravet syndrome (DS) with different genotypes. METHODS: Patients with DS were recruited from different tertiary hospitals. Using a direct sequencing method and Multiplex Ligation-Dependent Probe Amplification (MLPA), genetic abnormalities were assessed within the exons and flanking introns of SCN1A gene, which encodes the α1 subunit of neuronal sodium channels. Patients were divided into SCN1A-positive and SCN1A-negative groups according to the results of genetic tests...
January 2016: Brain & Development
Bianca A Torres-Hernández, Lisa M Del Valle-Mojica, José G Ortíz
BACKGROUND: Anticonvulsant properties have been attributed to extracts of the herbal medicine Valeriana officinalis. Our aims were to examine the anticonvulsant properties of valerenic acid and valerian extracts and to determine whether valerian preparations interact with the activity of other anti-epileptic drugs (phenytoin or clonazepam). To achieve these goals, we validated the adult zebrafish, Danio rerio, as an animal model for studying anticonvulsant drugs. METHODS: All drug treatments were administered by immersion in water containing the drug...
2015: BMC Complementary and Alternative Medicine
Elena Peila, Paolo Mortara, Alessandro Cicerale, Lorenzo Pinessi
We report a case of a 15-year-old boy presenting with sudden attacks of hyperkinetic movements of the limbs, trunk and neck. Clinical features were suggestive of paroxysmal non-kinesigenic dyskinesia, but the elevated antistreptolysin O antibody titre and history of recurrent upper airways infection led us to consider a post-streptococcal syndrome as a possible diagnosis. The patient started therapy with benzathine penicillin, sodium valproate and clonazepam without any significant improvement. A successive psychiatric assessment revealed the presence of a psychogenic movement disorder...
2015: BMJ Case Reports
Andrew C DeGiorgio, Tamara E Desso, Lance Lee, Christopher M DeGiorgio
We report a case of sustained ventricular tachycardia following the initiation of lacosamide as adjunctive epilepsy treatment. A 49-year-old male with intractable frontal lobe seizures experienced severe ventricular tachycardia following the addition of 400 mg lacosamide to his existing regimen of carbamazepine, lamotrigine, clonazepam, and valproate. The tachycardia occurred during a cardiac stress test; stress tests prior to initiation of lacosamide were normal. Conduction defects, including QRS prolongation, persisted during hospitalization until lacosamide was discontinued...
2013: Epilepsy & Behavior Case Reports
Philippe Gélisse, Arielle Crespel
Myoclonic status epilepticus or mixed absence-myoclonic status is uncommon in juvenile myoclonic epilepsy (JME), often precipitated by sleep deprivation, withdrawal of medication, or inadequate antiepileptic drugs (Thomas et al., 2006; Crespel et al., 2013). Such episodes respond well to benzodiazepines or valproate (Crespel et al., 2013). We present the video-EEG of a 24-year-old woman with JME and bipolar disorder. She had a confusional state five days after withdrawal of clonazepam (14 mg/d) and introduction of oxazepam (200 mg/d), followed by catatonic stupor with subtle myoclonus of the face and the arms...
March 2015: Epileptic Disorders: International Epilepsy Journal with Videotape
Minako Ide, Takeo Kato, Masatoshi Nakata, Keiko Saito, Takeshi Yoshida, Tomonari Awaya, Toshio Heike
BACKGROUND: Rufinamide, a triazole derivative, is a novel antiepileptic drug (AED) chemically unrelated to other current AEDs. Previous studies on pediatric epilepsy treatment with rufinamide have demonstrated a frequency of leukopenia as an adverse event of 0.5%, and there has been no report of the development of agranulocytosis. Here, we report a patient with Lennox-Gastaut syndrome (LGS) who developed agranulocytosis associated with fever and skin rash with rufinamide. To the best of our knowledge, this is the first reported case of agranulocytosis induced by rufinamide...
September 2015: Brain & Development
A S Kotov
Objective. To analyze epileptic seizure aggravation associated with antiepileptic drugs (AED) in adult patients. Material and methods. We examined 1407 patients aged 18-89 years. Different patterns of seizure aggravation were identified in 103 patients. Results. Aggravated seizures due the generic substitution were found in 32 patients. First was topiramate (TPM) (n=12), followed by valproates (VPA) (n=8), carbamazepine (CBZ) (n=5), lamotrigine (LTG) (n=1) and levetiracetam (LEV) (n=1). Patients with idiopathic generalized epilepsies (IGE) suffered aggravation with CBZ in 17 cases, VPA - in 6, TPM - in 6, LTG - in 1 and LEV - in 1...
2014: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
Raman Sankar, Steve Chung, Michael Scott Perry, Ruben Kuzniecky, Saurabh Sinha
INTRODUCTION: In treating refractory epilepsy, many clinicians are interested in methods used to transition patients receiving clonazepam to clobazam to maintain or increase seizure control, improve tolerability of patients' overall drug therapy regimens, and to enhance quality of life for patients and their families. However, no published guidelines assist clinicians in successfully accomplishing this change safely. CASE PRESENTATIONS: The following three case reports provide insight into the transition from clonazepam to clobazam...
2014: Journal of Medical Case Reports
Shuichi Shimakawa, Shohei Nomura, Motoko Ogino, Miho Fukui, Mitsuru Kashiwagi, Takuya Tanabe, Hiroshi Tamai
INTRODUCTION: In the chronic phase of Hemiconvulsion-Hemiplegia-Epilepsy (HHE) syndrome, developing epilepsy may be intractable. Herein, we report a case where adrenocorticotropic hormone (ACTH) ceased an intractable habitual partial seizure in a patient with HHE syndrome. CASE REPORT: A developmentally normal one-year-old girl presented with left focal motor status epilepticus in the clinical course of rotavirus infection. She was diagnosed with HH syndrome. At 4 months after status epilepticus, she developed partial seizures that occurred daily, and which resulted in a stooped posture, head rotation to the right, and contraction of both upper limbs predominantly in the left arm...
August 2015: Brain & Development
Ichiro Kuki, Hisashi Kawawaki, Shin Okazaki, Hiroko Ikeda, Kiyotaka Tomiwa
We encountered two patients with acquired Kanji dysgraphia in whom continuous spikes and waves, dominant in the occipito-temporal region, were recorded during slow-wave sleep. Electrical status epileptics during sleep (ESES) was demonstrated on overnight electroencephalography, and dipoles clustered in and around the posterior inferior temporal cortex on magnetoencephalography. Functional neuroimaging suggested dysfunction in the left posterior temporal lobe, including the posterior inferior temporal cortex...
December 2014: Epileptic Disorders: International Epilepsy Journal with Videotape
Sandeep Grover, Ajit Avasthi, Vishal Sinha, Bhavesh Lakdawala, Manish Bathla, Sujata Sethi, D M Mathur, Puneet Kathuria, Sandip Shah, D Sai Baalasubramanian, Vivek Agarwal, Kamla Deka
BACKGROUND: There is a lack of national level data from India on prescription of psychotropics by psychiatrists. AIM AND OBJECTIVE: This study aimed to assess the first prescription handed over to the psychiatrically ill patients whenever they contact a psychiatrist. MATERIALS AND METHODS: Data were collected across 11 centers. Psychiatric diagnosis was made as per the International Classification of Diseases Classification of Mental and Behavioural Disorders 10(th) edition criteria based on Mini International Neuropsychiatric Interview, and the data of psychotropic prescriptions was collected...
July 2014: Indian Journal of Psychiatry
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