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https://www.readbyqxmd.com/read/28436001/gait-instability-in-valproate-treated-patients-call-to-measure-ammonia-levels
#1
S Kipervasser, C E Elger, A D Korczyn, R D Nass, C M Quesada, M Y Neufeld
OBJECTIVE: Hyperammonemia induced by valproate (VPA) treatment may lead to several neurological and systemic symptoms as well as to seizure exacerbation. Gait instability and recurrent falls are rarely mentioned as symptoms, especially not as predominant ones. METHODS: We report five adult patients with frontal lobe epilepsy (FLE) who were treated with VPA and in whom a primary adverse effect was unstable gait and falls. RESULTS: There were four males and one female patients with FLE, 25-42-year-old, three following epilepsy surgery...
April 23, 2017: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/28434203/topiramate-monotherapy-for-juvenile-myoclonic-epilepsy
#2
REVIEW
Jia Liu, Lu-Ning Wang, Yu-Ping Wang
BACKGROUND: Topiramate is a newer broad-spectrum antiepileptic drug (AED). Some studies have shown the benefits of topiramate monotherapy in the treatment of juvenile myoclonic epilepsy (JME). However, there are no current systematic reviews to determine the efficacy and tolerability of topiramate monotherapy in people with JME. This is an updated version of the original Cochrane Review published in Issue 12, 2015. OBJECTIVES: To evaluate the efficacy and tolerability of topiramate monotherapy in the treatment of JME...
April 23, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28424947/neurodevelopmental-effects-of-antiepileptic-drugs
#3
Marissa Kellogg, Kimford J Meador
Increasing evidence suggests that exposure to certain antiepileptic drugs (AEDs) during critical periods of development may induce transient or long-lasting neurodevelopmental deficits across cognitive, motor and behavioral domains. The developing nervous system may endure prolonged chronic exposure to AEDs during pregnancy (in utero) or during childhood, which can lead to neurodevelopmental defects such as congenital neural tube defects, lower IQ, language deficits, autism and ADHD. To date, valproate is the most widely recognized AED to significantly negatively affect neurodevelopment, and demonstrates greater adverse effects than any other AEDs that have been assessed...
April 19, 2017: Neurochemical Research
https://www.readbyqxmd.com/read/28423937/concordance-of-several-subcellular-interactions-initiates-alzheimer-s-dementia-their-reversal-requires-combination-treatment
#4
W J Fessel
The pathogenesis of Alzheimer's disease involves multiple pathways that, at the macrolevel, include decreased proliferation plus increased loss affecting neurons, astrocytes, and capillaries and, at the subcellular level, involve several elements: amyloid/amyloid precursor protein, presenilins, the unfolded protein response, the ubiquitin/proteasome system, the Wnt/catenin system, the Notch signaling system, mitochondria, mitophagy, calcium, and tau. Data presented show the intimate, anatomical interactions between neurons, astrocytes, and capillaries; the interactions between the several subcellular factors affecting those cells; and the treatments that are currently available and that might correct dysfunctions in the subcellular factors...
May 2017: American Journal of Alzheimer's Disease and Other Dementias
https://www.readbyqxmd.com/read/28423558/biological-basis-and-clinical-study-of-glycogen-synthase-kinase-3%C3%AE-targeted-therapy-by-drug-repositioning-for-glioblastoma
#5
Takuya Furuta, Hemragul Sabit, Yu Dong, Katsuyoshi Miyashita, Masashi Kinoshita, Naoyuki Uchiyama, Yasuhiko Hayashi, Yutaka Hayashi, Toshinari Minamoto, Mitsutoshi Nakada
BACKGROUND: Glycogen synthase kinase (GSK)-3β has emerged as an appealing therapeutic target for glioblastoma (GBM). Here, we investigated the therapeutic effect of the current approved drugs against GBM via inhibition of GSK3β activity both, in experimental setting and in a clinical study for recurrent GBM patients by repositioning existent drugs in combination with temozolomide (TMZ). MATERIALS AND METHODS: Progression-free and overall survival rates were compared between patients with low or high expression of active GSK3β in the primary tumor...
April 4, 2017: Oncotarget
https://www.readbyqxmd.com/read/28418886/histone-hypoacetylation-contributes-to-cxcl12-downregulation-in-colon-cancer-impact-on-tumor-growth-and-cell-migration
#6
Benoît Romain, Radhia Benbrika-Nehmar, Laetitia Marisa, Michèle Legrain, Viviane Lobstein, Attila Oravecz, Laetitia Poidevin, Cyril Bour, Jean-Noël Freund, Isabelle Duluc, Dominique Guenot, Erwan Pencreach
CXCL12 has been shown to be involved in colon cancer metastasis, but its expression level and molecular mechanisms regulating its expression remain controversial. We thus evaluated CXCL12 expression in a large cohort of colon adenomas and carcinomas, investigated for an epigenetic mechanism controlling its expression and evaluated the impact of CXCL12 levels on cell migration and tumor growth. CXCL12 expression was measured in human colon adenomas and carcinomas with transcriptome array and RT-qPCR. The promoter methylation was analyzed with whole-genome DNA methylation chips and protein expression by immunohistochemistry...
March 17, 2017: Oncotarget
https://www.readbyqxmd.com/read/28417647/mixed-states-in-bipolar-disorder-changes-in-dsm-5-and-current-treatment-recommendations
#7
Felix Betzler, Laura Apollonia Stöver, Philipp Sterzer, Stephan Köhler
OBJECTIVE: Mixed states in affective disorders represent a particular challenge in clinical routine, characterized by a complicated course of treatment and a worse treatment response. METHODS: Clinical features of mixed states and the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria are presented and critical discussed. We then performed a systematic review using the terms 'bipolar', 'mixed' and 'randomized' to evaluate current treatment options...
April 18, 2017: International Journal of Psychiatry in Clinical Practice
https://www.readbyqxmd.com/read/28412607/effect-of-early-postnatal-exposure-to-valproate-on-neurobehavioral-development-and-regional-bdnf-expression-in-two-strains-of-mice
#8
Kevin G Bath, Tiare Pimentel
Valproate has been used for over 30years as a first-line treatment for epilepsy. In recent years, prenatal exposure to valproate has been associated with teratogenic effects, limiting its use in women that are pregnant or of childbearing age. However, despite its potential detrimental effects on development, valproate continues to be prescribed at high rates in pediatric populations in some countries. Animal models allow us to test hypotheses regarding the potential effects of postnatal valproate exposure on neurobehavioral development, as well as identify potential mechanisms mediating observed effects...
April 12, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28411969/valproate-induced-hyperammonemic-encephalopathy-in-general-hospital-patients-with-one-or-more-psychiatric-disorders
#9
Chandani Lewis, George E Tesar, Roman Dale
BACKGROUND: Divalproex sodium/valproic acid (VPA) is an antiepileptic drug approved for use in epilepsy and bipolar disorder. Valproate-induced hyperammonemia occurs in up to 50% of VPA-treated patients, some of whom may become encephalopathic. Valproate-induced hyperammonemic encephalopathy (VHE) is thought to be rare, and for a variety of reasons, the diagnosis requires a high index of suspicion. OBJECTIVE: The study's goals are to determine how common VHE is, and the quality of treatment provided when diagnosed...
February 24, 2017: Psychosomatics
https://www.readbyqxmd.com/read/28407518/evaluating-executive-function-in-patients-with-temporal-lobe-epilepsy-using-the-frontal-assessment-battery
#10
Elmira Agah, Nasima Asgari-Rad, Mona Ahmadi, Abbas Tafakhori, Vajiheh Aghamollaii
Previous studies have demonstrated executive dysfunction in patients with temporal lobe epilepsy (TLE). Frontal assessment battery (FAB) is a short neuropsychological tool that was developed for assessment of frontal lobe function in a clinical setting. The aim of the present study is to evaluate the clinical utility of FAB for detection of executive dysfunction in TLE patients. Forty-eight TLE patients and 48 sex and age-matched healthy controls participated in this study. Compared to healthy participants, the total FAB score was significantly lower among the TLE patients...
April 5, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28405886/pharmacokinetic-variability-of-drugs-used-for-prophylactic-treatment-of-migraine
#11
REVIEW
Peer Tfelt-Hansen, Frederik Nybye Ågesen, Agniezka Pavbro, Jacob Tfelt-Hansen
In this review, we evaluate the variability in the pharmacokinetics of 11 drugs with established prophylactic effects in migraine to facilitate 'personalized medicine' with these drugs. PubMed was searched for 'single-dose' and 'steady-state' pharmacokinetic studies of these 11 drugs. The maximum plasma concentration was reported in 248 single-dose and 115 steady-state pharmacokinetic studies, and the area under the plasma concentration-time curve was reported in 299 single-dose studies and 112 steady-state pharmacokinetic studies...
April 12, 2017: CNS Drugs
https://www.readbyqxmd.com/read/28403092/hyperammonemic-coma-after-craniotomy-hepatic-encephalopathy-from-upper-gastrointestinal-hemorrhage-or-valproate-side-effect-case-report-and-literature-review
#12
Xiaopeng Guo, Junji Wei, Lu Gao, Bing Xing, Zhiqin Xu
RATIONALE: Postoperative coma is not uncommon in patients after craniotomy. It generally presents as mental state changes and is usually caused by intracranial hematoma, brain edema, or swelling. Hyperammonemia can also result in postoperative coma; however, it is rarely recognized as a potential cause in coma patients. Hyperammonemic coma is determined through a complicated differential diagnosis, and although it can also be induced as a side effect of valproate (VPA), this cause is frequently unrecognized or confused with upper gastrointestinal hemorrhage (UGH)-induced hepatic encephalopathy...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28401072/the-investigation-of-insulin-resistance-in-two-groups-of-epileptic-patients-treated-with-sodium-valproate-and-carbamazepine
#13
Mohammad Reza Najafi, Bahareh Bazooyar, Mohammad Zare, Mohammad Reza Aghaghazvini, Behnaz Ansari, Ali Rajaei, Masoumeh Dashti
BACKGROUND: Valproic acid (VPA) is a widely used broad-spectrum antiepileptic drug for therapy of generalized and focal epilepsies. Cross-sectional studies have suggested that valproate treatment may be associated with hyperinsulinemia. We decided to investigate hyperinsulinemia as a health-threatening side effect of VPA in Iranian epileptic patients. MATERIALS AND METHODS: Body mass index (BMI), lipid profile, fasting serum insulin, fasting blood glucose (FBS), and homeostatic model assessment-insulin resistance (HOMA-IR) were measured in 30 VPA-treated epileptic patients and 30 controls (CBZ-treated)...
2017: Advanced Biomedical Research
https://www.readbyqxmd.com/read/28397652/-scientific-evidence-on-treatment-and-prognosis-of-childhood-absence-epilepsy
#14
Joakim Bloch, Maria J Miranda
Until now, ethosuximide (ESM), sodium valproate (VPA) and lamotrigine have been considered the drugs of choice in the management of childhood absence epilepsy, and there has been no high-validated evidence to distinguish their effects. New research shows, however, that while VPA and ESM are equally effective, ESM is the best tolerated of the two drugs, when considering cognitive adverse effects. This is of major importance, as cognitive comorbidities can be dire in childhood absence epilepsy, possibly affecting the psychosocial prognosis of the patients...
March 27, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28396847/patch-testing-and-cross-sensitivity-study-of-adverse-cutaneous-drug-reactions-due-to-anticonvulsants-a-preliminary-report
#15
T N Shiny, Vikram K Mahajan, Karaninder S Mehta, Pushpinder S Chauhan, Ritu Rawat, Rajni Sharma
AIM: To evaluate the utility of patch test and cross-sensitivity patterns in patients with adverse cutaneous drug reactions (ACDR) from common anticonvulsants. METHODS: Twenty-four (M:F = 13:11) patients aged 18-75 years with ACDR from anticonvulsants were patch tested 3-27 mo after complete recovery using carbamazepine, phenytoin, phenobarbitone, lamotrigine, and sodium valproate in 10%, 20% and 30% conc. in pet. after informed consent. Positive reactions persisting on D3 and D4 were considered significant...
March 26, 2017: World Journal of Methodology
https://www.readbyqxmd.com/read/28391250/confirmation-of-mutations-in-prosc-as-a-novel-cause-of-vitamin-b6-dependent-epilepsy
#16
Barbara Plecko, Markus Zweier, Anaïs Begemann, Deborah Mathis, Bernhard Schmitt, Pasquale Striano, Martina Baethmann, Stella Maria Vari, Francesca Beccaria, Federico Zara, Lisa M Crowther, Pascal Joset, Heinrich Sticht, Sorina Mihaela Papuc, Anita Rauch
Vitamin-B6-dependent epilepsies are a heterogenous group of treatable disorders due to mutations in several genes (ALDH7A1, PNPO, ALPL or ALDH4A1). In neonatal seizures, defects in ALDH7A1 and PNPO explain a major fraction of cases. Very recently biallelic mutations in PROSC were shown to be a novel cause in five families. We identified four further unrelated patients harbouring a total of six different mutations, including four novel disease mutations. Vitamin B6 plasma profiles on pyridoxine did not enable the differentiation of patients with PROSC mutations...
April 8, 2017: Journal of Medical Genetics
https://www.readbyqxmd.com/read/28370224/do-antiepileptic-drugs-increase-the-risk-of-infectious-diseases-a-meta-analysis-of-placebo-controlled-studies
#17
Gaetano Zaccara, Fabio Giovannelli, Filippo Sean Giorgi, Valentina Franco, Sara Gasparini, Francesco Mandò Tacconi
AIMS: Experimental studies show that some antiepileptic drugs (AEDs) may modify natural immune defenses, thus influencing the risk of developing infectious diseases. The aim of this meta-analysis was to explore whether AEDs as a class of drugs or singularly may increase risk of infectious diseases. METHODS: A meta-analysis of all randomized, double-blind, placebo-controlled trials (RCTs) investigating any AED in any condition was performed. All terms which could be coded in the System Organ Classes (SOCs) of "infections and infestations" using the Medical Dictionary for Regulatory Activities (MedDRA) were recorded...
March 31, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28366991/supplementation-with-carnitine-reduces-the-severity-of-constipation-a-retrospective-study-of-patients-with-severe-motor-and-intellectual-disabilities
#18
Shinya Murata, Keisuke Inoue, Tomoki Aomatsu, Atsushi Yoden, Hiroshi Tamai
Carnitine is an essential nutrient for the mitochondrial transport of fatty acids. Carnitine deficiency causes a variety of symptoms in multiple organs. Patients with severe motor and intellectual disabilities often have carnitine deficiency. This study aimed to determine the correlation between constipation and carnitine deficiency in them. Patients with severe motor and intellectual disabilities at our hospital were retrospectively reviewed. The correlation between level of free carnitine and severity of constipation was examined...
March 2017: Journal of Clinical Biochemistry and Nutrition
https://www.readbyqxmd.com/read/28366540/valproate-induced-hepatic-steatosis-by-enhanced-fatty-acid-uptake-and-triglyceride-synthesis
#19
Xupeng Bai, Weipeng Hong, Peiheng Cai, Yibei Chen, Chuncao Xu, Di Cao, Weibang Yu, Zhongxiang Zhao, Min Huang, Jing Jin
Steatosis is the characteristic type of VPA-induced hepatotoxicity and may result in life-threatening hepatic lesion. Approximately 61% of patients treated with VPA have been diagnosed with hepatic steatosis through ultrasound examination. However, the mechanisms underlying VPA-induced intracellular fat accumulation are not yet fully understood. Here we demonstrated the involvement of fatty acid uptake and lipogenesis in VPA-induced hepatic steatosis in vitro and in vivo by using quantitative real-time PCR (qRT-PCR) analysis, western blotting analysis, fatty acid uptake assays, Nile Red staining assays, and Oil Red O staining assays...
June 1, 2017: Toxicology and Applied Pharmacology
https://www.readbyqxmd.com/read/28365440/evaluate-the-effects-of-long-term-valproic-acid-treatment-on-metabolic-profiles-in-newly-diagnosed-or-untreated-female-epileptic-patients-a-prospective-study
#20
Harpreet Singh Sidhu, R Srinivas, Akshay Sadhotra
PURPOSE: Excessive weight gain associated with sodium valproate (VPA) may predispose patients with epilepsy to other health problems such as insulin resistance. We prospectively evaluated the long-term impact of VPA monotherapy compared with lamotrigine (LTG) monotherapy on anthropometric and metabolic parameters in women with epilepsy. Our primary objective is to understand the underlying mechanism responsible for VPA-induced obesity. METHODS: Sixty-six female patients with newly diagnosed or untreated epilepsy were included in the study...
March 22, 2017: Seizure: the Journal of the British Epilepsy Association
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