Allopurinol in Severe Epilepsy

Marco, P. De; Zagnoni, P.

doi:10.1159/000118433

Cited by 16 publications

(9 citation statements)

References 2 publications

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“…2C) as adjunctive therapy is effective in seizure reduction [172][173][174][175][176], in which allopurinol may act via a decrease of Ado and/or Guo degradation and an HGPRT-induced increase in Ado and Guo levels (Fig. 1) [30,173].…”

Section: Modulation Of Adenosine Levels and Epileptic Activity By Metmentioning

confidence: 99%

The Antiepileptic Potential of Nucleosides

Kovács¹,

Kékesi²,

Juhász³

et al. 2014

CMC

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Despite newly developed antiepileptic drugs to suppress epileptic symptoms, approximately one third of patients remain drug refractory. Consequently, there is an urgent need to develop more effective therapeutic approaches to treat epilepsy. A great deal of evidence suggests that endogenous nucleosides, such as adenosine (Ado), guanosine (Guo), inosine (Ino) and uridine (Urd), participate in the regulation of pathomechanisms of epilepsy. Adenosine and its analogues, together with non-adenosine (non-Ado) nucleosides (e.g., Guo, Ino and Urd), have shown antiseizure activity. Adenosine kinase (ADK) inhibitors, Ado uptake inhibitors and Ado-releasing implants also have beneficial effects on epileptic seizures. These results suggest that nucleosides and their analogues, in addition to other modulators of the nucleoside system, could provide a new opportunity for the treatment of different types of epilepsies. Therefore, the aim of this review article is to summarize our present knowledge about the nucleoside system as a promising target in the treatment of epilepsy.

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Section: Modulation Of Adenosine Levels and Epileptic Activity By Metmentioning

confidence: 99%

The Antiepileptic Potential of Nucleosides

Kovács¹,

Kékesi²,

Juhász³

et al. 2014

CMC

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“…Six patients with LGS, from 41 epileptic non-hyperuricemic subjects, aged 2–54 years, already medicated with 2 or 3 AEDs were treated with ALL in doses ranging from 150 to 300 mg daily (DeMarco and Zagnoni 1986). A progressive decrease in the weekly seizure frequency was observed in two-thirds of the cases in this open-label study.…”

Section: Chronic Medical Treatmentmentioning

confidence: 99%

Treatment of Lennox-Gastaut syndrome: overview and recent findings

Rijckevorsel¹

2008

NDT

118

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Lennox-Gastaut syndrome (LGS) is a rare, age-related syndrome, characterized by multiple seizure types, a specifi c electro-encephalographic pattern, and mental regression. However, published data on the etiology, evolution, and therapeutic approach of LGS are contradictory, partly because the precise defi nition of LGS used in the literature varies. In the most recent classifi cation, LGS belongs to the epileptic encephalopathies and is highly refractory to all antiepileptic drugs. Numerous treatments, medical and non-medical, have been proposed and results mostly from open studies or case series have been published. Sometimes, patients with LGS are included in a more global group of patients with refractory epilepsy. Only 6 randomized double-blind controlled trials of medical treatments, which included patients with LGS, have been published. Overall, treatment is rarely effective and the fi nal prognosis remains poor in spite of new therapeutic strategies. Co-morbidities need specifi c treatment. This paper summarizes the defi nition, diagnosis and therapeutic approach to LGS, including not only recognized antiepileptic drugs, but also "off label" medications, immune therapy, diet, surgery and some perspectives for the future.

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“…Data in humans suggest that the purinergic pathway is altered during an epileptic seizure: an increase in oxipurines was observed in children after episodes of status epilepticus (Manzke et al,198l), and seizures occurring in patients with hyperuricosuria were reported to show a favorable response to allopurinol (Coleman et al, 1974(Coleman et al, , 1986. Based on these findings, uncontrolled clinical trials were performed in patients with refractory epilepsy and yielded conflicting results (DeMarco and Zagnoni, 1986;Guzeva et al, 1988;Sander and Patsalos, 1988;Tada et al, 1991). Our randomized, placebo-controlled trial was designed to investigate the possible antiepileptic action of allopurinol in a large population of patients with refractory epilepsy.…”

mentioning

confidence: 99%

Allopurinol as Add‐on Therapy in Refractory Epilepsy: A Double‐Blind Placebo‐Controlled Randomized Study Italy, on his retirement.

Zagnoni¹,

Bianchi

Zolo

et al. 1994

Epilepsia

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The antiepileptic effect of allopurinol was assessed in a double-blind, randomized, placebo-controlled, cross-over trial in 84 patients with epileptic seizures refractory to standard antiepileptic drugs (AEDs). During a retrospective baseline period, patients experienced at least four seizures of any type per month. The effects of allopurinol and matching placebo were examined for 4-month periods. Allopurinol dosage was 150 mg daily for children weighing < 20 kg and 300 mg daily for other patients. Efficacy analysis based on the Wilcoxon rank-sum test was conducted for the 80 patients who completed the study. No significant period effect or treatment-period interaction was noted. Allopurinol significantly reduced total seizures (p = 0.005), and secondarily generalized seizures (p = 0.0015). Median seizure reduction for total seizures was 10.5 and 27.9% for secondarily generalized seizures. Subjective preferences by clinicians evaluated blindly significantly favored allopurinol. No significant change occurred in the plasma concentration of concomitant AEDs between treatment periods, but serum urate decreased by 32% during allopurinol treatment. No clinically relevant side effects or changes in routine laboratory clinical chemistry or hematology were ascribed to allopurinol.

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Allopurinol in Severe Epilepsy

Cited by 16 publications

References 2 publications

The Antiepileptic Potential of Nucleosides

The Antiepileptic Potential of Nucleosides

Treatment of Lennox-Gastaut syndrome: overview and recent findings

Allopurinol as Add‐on Therapy in Refractory Epilepsy: A Double‐Blind Placebo‐Controlled Randomized Study Italy, on his retirement.

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