Side-effects of drug treatment in epilepsy

Dam, M.

doi:10.1111/j.1600-0404.1988.tb08001.x

Cited by 4 publications

(3 citation statements)

References 57 publications

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“…[19,20,23,33,73,80] In addition, the recognition of side effects caused by anticonvulsant therapy have positively influenced the trend for alternative management strategies. [24] Debate, however, still persists on the indications and timing of surgery in children. It is doubtful whether selection criteria used to choose adult patients are suitable for children.…”

Section: Discussionmentioning

confidence: 99%

Surgery in epilepsy associated with focal lesions in childhood

Bourgeois¹,

Sainte‐Rose²,

Lellouch‐Tubiana³

et al. 1999

FOC

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Surgery in children with epilepsy is a new, evolving field. The important practical issues have been to define strategies for choosing the most suitable candidates, as well as the type and the optimum timing of epilepsy surgery. This study was undertaken to illustrate these points. To identify the factors that correlated with outcome, the authors analyzed a series of 200 children (aged 1–15 years, mean 8.7 years) who underwent surgery at the Hôpital Necker-Enfants Malades between 1981 and 1996. In 171 cases (85.5%) the epilepsy was medically refractory and was associated with focal cortical lesions. Surgery consisted of resection of the lesion without specifically attempting to identify and remove the "epileptogenic area." In the group of children whose seizures were medically refractory, the mean follow-up period was 5.8 years. According to Engel's classification, 71.3% of these children became seizure free (Ia), whereas 82% were in Class I. A multivariate statistical analysis revealed that among all the factors studied, the success of surgery in a patient in whom there was a good clinical-electroencephalogram-imaging correlation, depended on the patients' having undergone a minimally traumatic operation, a complete resection of the lesion, and a short preoperative seizure duration. After the surgical control of epilepsy, behavior disorders were more improved (31% of all patients) than cognitive function (25%). The patient age at onset, duration and frequency of seizures, intractability of the disease to therapy, and seizure characteristics, were correlated with cognitive, behavioral, and academic performance pre- and postoperatively. Multivariate statistical analysis revealed that cognitive dysfunction correlated highly with the duration of epilepsy prior to surgery, whereas behavioral disorders correlated more with seizure frequency. These data must be taken into account when selecting patients for surgical treatment and when deciding the timing of surgery. Early surgical intervention allows for optimum brain development.

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Section: Discussionmentioning

confidence: 99%

Surgery in epilepsy associated with focal lesions in childhood

Bourgeois¹,

Sainte‐Rose²,

Lellouch‐Tubiana³

et al. 1999

FOC

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“…Side-effects of antiepileptic drugs impair the quality of life in epileptic patients and contribute considerably to diminishing the patients' compliance. The occurrence of such unwanted side-effects, however, is a common observation in the everyday practice of epilepsy-patient care [1], but quantitative data on the prevalence of side-effects in epileptic patient populations are rare [2][3][4]. The same applies to information on the possible correlation between antiepileptic drugs plasma concentrations and the occurrence of such side-effects.…”

Section: Introductionmentioning

confidence: 98%

Side-effects of drugs in epileptic patients

Termond

Theeuwes²,

Schaap

et al. 1990

Pharmaceutisch Weekblad Scientific Edition

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Drug therapy in patients suffering from various forms of epilepsy aims at the administration of such dosages of antiepileptic drugs as to produce significant reduction of seizures without the occurrence of serious side-effects. To assess these side-effects 75 patients (48 males, 27 females) with epilepsy, attending an out-patient clinic were studied prospectively and data were collected regarding diagnosis, drug use and side-effects. Primarily generalized epilepsy and partial complex epilepsy with secondary generalization are the most prevailing categories. 69% (52) Of the patients are treated with monotherapy, with carbamazepine as the drug most frequently prescribed (30/52). Side-effects were scored after examining and questioning the patient with the help of a standard questionnaire. A distinction was made between groups of side-effects, being systemic, anamnestic, dermatological, neurological or miscellaneous. Also, haematological and biochemical changes were looked for. In the monotherapy group 26/52 (50%) of the patients showed side-effects (23 patients with 1, 2 with 2, 1 with 3 side-effects), and in the polytherapy group 15/23 (65%) (8 patients with 1, 7 with 2 side-effects). Adverse drug reactions were hardly related to the plasma concentration category. Between 50-60% of the patients at sub-therapeutic and low-therapeutic plasma levels complained of side-effects. No clear relationship between the clinical efficacy and the side-effects could be established. The clinical custom, among others, to titrate the dose according to the disappearance or appearance of side-effects seems open for discussion.

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“…Ancak, uzun süreli tedavi bazı yan etkilere neden olabilmektedir. Kemik mineral metabolizması da etkilenmekte, kemiklerde yoğunluk azalmasından patolojik kırıklara kadar değişen durumlar gözlenebilmektedir (1,2,3). Kemik mineral metabolizmasındaki değişiklikler serumda kalsiyum (Ca), fosfor (P), alkalen fosfataz (ALP), paratiroid hormon (PTH), 25-(OH)D3, osteokalsin düzeylerinin ve kemik mineral yoğunluğunun (KMY) ölçülmesi ile değerlendirilmektedir (4)(5)(6)(7).…”

Section: Introductionunclassified

Antiepileptik İlaç Kullanan Çocuklarda Kemik Mineral Metabolizmasının Değerlendirilmesi

GENÇLER,

KARASALİHOĞLU

2023

Harran Üniversitesi Tıp Fakültesi Dergisi

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Amaç: Bu çalışmada çocukluk çağı epilepsilerinde yaygın kullanımda olan antiepileptik ilaçların, hastaların kemik mineral metabolizmasında yaptığı değişiklikler araştırılırken, daha kolay ve düşük maliyetli parametrelerden olan Kalsitriol İndeks ve PTH İndeksinin bu hastaların takiplerinde kullanılabilirliği amaçlandı. Materyal-Metod: Çalışmaya hastanemizin çocuk nöroloji polikliniğinde idiopatik epilepsi tanısı konularak ilk kez antiepileptik tedavi (valproik asit, karbamazepine, fenobarbital) başlanan 3-14 yaş arası 55 hasta ve benzer demogrofik özellikteki 32 kontrol olgu dahil edildi. İlaç başlanmadan önce ve tedavi başlandıktan en az 6-12 ay sonra hastaların serumundan kalsiyum (Ca), fosfor (P), Alkalen fosfataz (ALP), Paratiroid Hormon (PTH), 25-(OH)D3, osteokalsin düzeyleri bakıldı, PTH İndeksi, Kalsitriol İndeksi hesaplandı. Bulgular: Hastalarının ilaç kullanım öncesi değerleri, ilaç kullanım sonrası ve kontrol grubu değerleri ile karşılaştırıldığında Ca değerleri arasında anlamlı fark bulunmazken, P ve 25-(OH)D3 düzeyleri anlamlı olarak düşüktü (sırasıyla p<0,001, p<0,001). Alkalen fosfataz, PTH ve osteokalsin düzeyleri anlamlı olarak yüksek saptandı (sırasıyla p<0,05, p<0,004, p<0,001). Hasta grubunun Kalsitriol İndeks ve PTH İndeks parametreleri de anlamlı olarak düşük bulundu (sırasıyla p<0,001, p<0,001). Olguların ilaç kullanım sonrasındaki biyokimyasal parametreleri raşitizm evrelemesine göre evrelendirildi. Buna göre 8 (%14) olgu evre 2 raşitizm bulguları gösteriyordu. Bu 8 olgu baz alındığında; PTH ile PTH İndeksinin duyarlılık, özgüllük, pozitif prediktif, negatif prediktif değerleri yüksek bulundu. Kalsitriol indeksin duyarlılığı düşüktü. Bununla birlikte PTH İndeksi ile PTH, Kalsitriol İndeks ile D vitamini arasında değersel korelasyon kurulamadı. Buna ilişkin olarak PTH indeksinin PTH düzeyini yansıtmadığı halde, osteopenik olguları değerlendirmede PTH ve PTH indeksinin değerli olduğunu sonucuna vardık. Kemik mineral ölçümleri evre 2 raşitizm bulguları gösteren 8 olguda yapıldığında referans değerlere göre normal olduğu gözlendi. Sonuç: Valproik asit, karbamazepine, fenobarbital alan hastalarda kemik mineral metabolizması etkilenmekte, bu hastalarda biyokimyasal değişiklikler ortaya çıkmaktadır. Tanı ve takipte tüm parametrelerin birlikte kullanılması tanısal değeri arttırmaktadır. Ama bunun yanı sıra PTH ve PTH İndeksi de raşitizm evrelemesine göre osteopenik olguları belirlemede kullanılabilecek değerli parametreler arasında yer alabilir.

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Side-effects of drug treatment in epilepsy

Cited by 4 publications

References 57 publications

Surgery in epilepsy associated with focal lesions in childhood

Surgery in epilepsy associated with focal lesions in childhood

Side-effects of drugs in epileptic patients

Antiepileptik İlaç Kullanan Çocuklarda Kemik Mineral Metabolizmasının Değerlendirilmesi

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