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5-17-13 Estraderm TTS therapy of osteoporosis during menopause in women with epilepsy
Headache
S302
We randomized 32 newly diagnosed patients (mean age 32 f 15 years) to either vigabatrin (GVG) or carbamazepine (CBZ) monotherapy in a doubls-blind study. Quantitative MRI with a 1.5-T MRI and memory assessment were performed at baseline and after one year and two years of successful treatment. There were no change in hippocampal or amygadala volumes or T2 relaxation times during the follow-up independently of the drug used or the clinical outcome. Neither GVG or CBZ therapy was associated with T2 changes in temporal or panetal white matter or in thalamus. Memory scores correlated inversely with hippccampal volumes and GVG patients seemed to benefit from practice effect as compared with CBZ patients. In conclusion, during two-year drug treatment there are no changes that would indicate progression of neuronal damage in newly diagnosed patients.
5-17 L-l
13
Estraderm lTS therapy of osteoporosis menopause in women with epilepsy
D. RoSciszewska, Medical Academy
J. Nowakowska. Zabrze, Poland
Department
of rVeuro/ogx
during
5-l 7-16 n
Silesian
Effect of estrogen therapy on osteoporosis was evaluated including influence on seizure frequency. Eight women aged 51-64 years with epilepsy (mean disease duration 29.2 f 17.1 years) and with osteoporosis (mean percentage of bone density deficit in relation to age amounted to 20.8% with range 9-47%), after endocrine and gynaecological examinations were treated with hormones for 12-15 months. In 3 cases menopause followed surgery, mean age of last menstruation 45.8 f 6.0 years. Estradiol and progesterone serum concentration fluctuated in lower range of norm. Estraderm TTS was applied transdermally (3 weeks with 1 week interval), progesterone (Provera) was introduced in the last 10 days. Estraderm 25 was used first, than Estraderm 50 was applied. Bone density examination by ultrasound method was repeated after 6 and 12 months of therapy. In 5 patients a certain increase of bone density was found. No increase of seizure frequency was observed. In 5 women frequency was unchanged and in 3 cases the seizures were rare. On the basis of experimental animal studies, it is known that estrogens may lower the threshold of seizures induced by electroshock. But, results obtained suggest that cyclic supplementary therapy with estrogens has no negative influence on epilepsy course in women with menopause.
5-17-14
Follow-up of 256 patients with epilepsy treated with new anticonvulsant drugs in a developing country
P. Said6n, B. Giagante, L. Gonzalez, M. DiEgidio, Ft. Berardo, E. Centurion, W. Silva, D. Consalvo, S. Kochen. Municipal Center of Epilepsy, Neurology Division, Ramos Mejia Hospital, Buenos Aires, Argentina
in persisting
absences during adult life
J. Salas-Puig, R. Ribacoba ‘, A. Tufton, R.S. Moro, CH. Lahoz. Department Neurology H. General, Oviedo, Spain, ’ Department of Neurology H. Meres, Otiedo, Spain
of
Introduction: Persistent absences in adult life is a rare condition that usually responds to the association of Sodium Valproate (VPA) and Ethosuximide (ESM). We report on the effectiveness of Lamotrigine (LTG) in a group of patients with this condition.
Neuropsychological epilepsy
A.R. Santos, L.E.B. Piske, M. Muszkat, de Toledo. 655, Szio Paolo
assessment A. Rassi.
in temporal
UN/FESP/EPMRua
lobe Pedro
The aim of this paper is to evaluated cognitive and neuropsychological aspects in patients with refractory temporal lobe epilepsy. Methods: 11 patients with temporal lobe epilepsy, 3 with left focus and 8 with right hemisphere candidate to temporal lobectomy were evaluated. The battery consist of Hooper (V.0.T); Stroop; Rey Picture: Boston N.T; Memory Wescheler Review; Luria’s visual and mot&e functions; F.A.S and Wais-R; R.A.V.L.T; R.V.D.L.T; involving cognitive training, attention visual memory; verbal fluency, visual learning and verbal skills. Resulta: visual learning and visual memory (visual reproduction-WMS-R; R.V.D.L.T and Rey Picture): we examined 3 patients with right hemisphere focus whose demonstrated the absence of memory’s strategies. While audio-verbal tasks included verbal fluency; memory and learning (Logical Memory W. MS-R; Boston N.T; R.A.V.L.T; F.A.S) showed appropriate to measure verbal abilities in patients with left hemisphere focus.
21
Headache
5-21-01
Purpose: In the last decades, five new anticonvulsant drugs were approved in our country: Oxcarbacepine (OXC) 1992, Vigabatrin (VGB) 1993, Felbamate (FBM) 1994, Lamotrfgine (LMT) 1994 and Gabapentin (GBP) in 1995. Methods: We analyzed the impact, efficacy, side effects and drugs withdrawal of this five new drugs. Results: From a total of 2191 p attending in our center, 736 were seen in the last two years; 256 (34.7%) of them were treated with new anticonvulsant drugs. From a total sample of 256 p, 221 p (86.3%) did not respond to treatment with classic antiepileptic drugs. In 204 p (80%) of the subjects the new drugs were used as add-on therapy (VGB n = 96; OXC n = 27; LMT n = 36; FBM n = 12; GBP n = 30) while in 51 p (20%) it was used as monotherapy (OXC n = 51). In 211 p (82.4%) had partial seizures, and 45 p (17.6%) generalized seizures. The epilepsy was symptomatic in 110 p (43%) and cryptogenic in 146 p (57%). We analyzed the percentage of seizures frequency reduction in a short time (3 months), and long time (12 months) for VGB, OXC, FBM, and LMT and in a short time for GBP because of its recent approval in our country. We analyzed also the withdrawal of the drugs because of the side effects, lost of efficacy, tolerance and other factors. It was VGB 21%, LMT 28%, FBM 21% and OXC in 10%. Conclusion: New anticonvulsant drugs are an important tool in the treatment of refractory epilepsy. In our country the main reasons for drugs withdrawal were economic, side effects, lack of efficacy or tolerance.
15-l 7-l 5 ] Lamotrigine
Patlents and Method: The studied group consisted of 10 subjects (5 male, 5 female) with a mean age of 38.7 years (23-65). The age at onset of absences was 8.6 y. (4-16). All suffered tonic-clonic seizures which begun at 16.9 y. (4-60). We recorded on the EEG typical absences in all the patients. 10 were treated with VPA and 7 with VPA+ESM. In spite of this treatment they continued to suffer frequent absences. The addition of LTG produced a complete control of absences in 4 (40%) and a reduction of >75% in 6 (60%) of the cases. The present treatment, after 24.6 months (10-38) with LTG, is the following: LTG: 2 cases; LTG+VPA: 7 cases; LTG+Primidone: 1 case. In two patients we tried LTG monotherapy but they required LTG+VPA to achieve a complete control of their seizures. Remarks: LTG is a very useful treatment for persisting absences during adult life. Some patients need the association of LTG and VPA to be seizurefree.
Effects of subcutaneous childhood migraine
sumatriptan
therapy in
Ali Akyol ’ , Bi.ilent Mungen 2, Mehmet Turgut ‘, Saadst Akarsu *, Eralp Bellibas ‘, Kemal Bayiilkem ‘. ’ Adnan Menderes University Hospital, Depts. of NeurolcgH Neurosurgery and Pharmawfog~ Aydm, Turkey; 2 firat University Hospital, Depts. of Neurology; Efazid, Turkey Background and Objectives: It is believed that the pathogenesis of migraine is primarily of vascular origin, the headache being associated with marked and prolonged phase of cranial vasodilatation. Sumatriptan constrict selectively distanded and inflammed cranial vessels by activating of 5HT 1 subtype receptors, durtng migraine attack. We aimed to show the effectiveness of subcutaneous sumatriptan therapy in childhood migraine. There is not enough study about these age group. Method: In this study, 15 children ranging in age from 6-15 years diagnosed as migraine were evaluated for their clinical features. Four patients subcutaneous sumatriptan of 3 mg dose and the others received the subcutaneous application of sumatriptan of 6 mg. Patients comments and adverse effects about the drug were evaluated after three subsequent usage. Results: There were some side-effects such as pain in the injection site and bad taste sensation in some patients. However, severity, frequency and duration of pain decreased in all of patients. Results were evaluated statistically (p < 0.01). Conclusions: We suggest that sumattiptan is an effective agent and tolerable drug during the acute migraine attack in pediatric age group, but we need further studies for the standard dosage in these patients.
S302
We randomized 32 newly diagnosed patients (mean age 32 f 15 years) to either vigabatrin (GVG) or carbamazepine (CBZ) monotherapy in a doubls-blind study. Quantitative MRI with a 1.5-T MRI and memory assessment were performed at baseline and after one year and two years of successful treatment. There were no change in hippocampal or amygadala volumes or T2 relaxation times during the follow-up independently of the drug used or the clinical outcome. Neither GVG or CBZ therapy was associated with T2 changes in temporal or panetal white matter or in thalamus. Memory scores correlated inversely with hippccampal volumes and GVG patients seemed to benefit from practice effect as compared with CBZ patients. In conclusion, during two-year drug treatment there are no changes that would indicate progression of neuronal damage in newly diagnosed patients.
5-17 L-l
13
Estraderm lTS therapy of osteoporosis menopause in women with epilepsy
D. RoSciszewska, Medical Academy
J. Nowakowska. Zabrze, Poland
Department
of rVeuro/ogx
during
5-l 7-16 n
Silesian
Effect of estrogen therapy on osteoporosis was evaluated including influence on seizure frequency. Eight women aged 51-64 years with epilepsy (mean disease duration 29.2 f 17.1 years) and with osteoporosis (mean percentage of bone density deficit in relation to age amounted to 20.8% with range 9-47%), after endocrine and gynaecological examinations were treated with hormones for 12-15 months. In 3 cases menopause followed surgery, mean age of last menstruation 45.8 f 6.0 years. Estradiol and progesterone serum concentration fluctuated in lower range of norm. Estraderm TTS was applied transdermally (3 weeks with 1 week interval), progesterone (Provera) was introduced in the last 10 days. Estraderm 25 was used first, than Estraderm 50 was applied. Bone density examination by ultrasound method was repeated after 6 and 12 months of therapy. In 5 patients a certain increase of bone density was found. No increase of seizure frequency was observed. In 5 women frequency was unchanged and in 3 cases the seizures were rare. On the basis of experimental animal studies, it is known that estrogens may lower the threshold of seizures induced by electroshock. But, results obtained suggest that cyclic supplementary therapy with estrogens has no negative influence on epilepsy course in women with menopause.
5-17-14
Follow-up of 256 patients with epilepsy treated with new anticonvulsant drugs in a developing country
P. Said6n, B. Giagante, L. Gonzalez, M. DiEgidio, Ft. Berardo, E. Centurion, W. Silva, D. Consalvo, S. Kochen. Municipal Center of Epilepsy, Neurology Division, Ramos Mejia Hospital, Buenos Aires, Argentina
in persisting
absences during adult life
J. Salas-Puig, R. Ribacoba ‘, A. Tufton, R.S. Moro, CH. Lahoz. Department Neurology H. General, Oviedo, Spain, ’ Department of Neurology H. Meres, Otiedo, Spain
of
Introduction: Persistent absences in adult life is a rare condition that usually responds to the association of Sodium Valproate (VPA) and Ethosuximide (ESM). We report on the effectiveness of Lamotrigine (LTG) in a group of patients with this condition.
Neuropsychological epilepsy
A.R. Santos, L.E.B. Piske, M. Muszkat, de Toledo. 655, Szio Paolo
assessment A. Rassi.
in temporal
UN/FESP/EPMRua
lobe Pedro
The aim of this paper is to evaluated cognitive and neuropsychological aspects in patients with refractory temporal lobe epilepsy. Methods: 11 patients with temporal lobe epilepsy, 3 with left focus and 8 with right hemisphere candidate to temporal lobectomy were evaluated. The battery consist of Hooper (V.0.T); Stroop; Rey Picture: Boston N.T; Memory Wescheler Review; Luria’s visual and mot&e functions; F.A.S and Wais-R; R.A.V.L.T; R.V.D.L.T; involving cognitive training, attention visual memory; verbal fluency, visual learning and verbal skills. Resulta: visual learning and visual memory (visual reproduction-WMS-R; R.V.D.L.T and Rey Picture): we examined 3 patients with right hemisphere focus whose demonstrated the absence of memory’s strategies. While audio-verbal tasks included verbal fluency; memory and learning (Logical Memory W. MS-R; Boston N.T; R.A.V.L.T; F.A.S) showed appropriate to measure verbal abilities in patients with left hemisphere focus.
21
Headache
5-21-01
Purpose: In the last decades, five new anticonvulsant drugs were approved in our country: Oxcarbacepine (OXC) 1992, Vigabatrin (VGB) 1993, Felbamate (FBM) 1994, Lamotrfgine (LMT) 1994 and Gabapentin (GBP) in 1995. Methods: We analyzed the impact, efficacy, side effects and drugs withdrawal of this five new drugs. Results: From a total of 2191 p attending in our center, 736 were seen in the last two years; 256 (34.7%) of them were treated with new anticonvulsant drugs. From a total sample of 256 p, 221 p (86.3%) did not respond to treatment with classic antiepileptic drugs. In 204 p (80%) of the subjects the new drugs were used as add-on therapy (VGB n = 96; OXC n = 27; LMT n = 36; FBM n = 12; GBP n = 30) while in 51 p (20%) it was used as monotherapy (OXC n = 51). In 211 p (82.4%) had partial seizures, and 45 p (17.6%) generalized seizures. The epilepsy was symptomatic in 110 p (43%) and cryptogenic in 146 p (57%). We analyzed the percentage of seizures frequency reduction in a short time (3 months), and long time (12 months) for VGB, OXC, FBM, and LMT and in a short time for GBP because of its recent approval in our country. We analyzed also the withdrawal of the drugs because of the side effects, lost of efficacy, tolerance and other factors. It was VGB 21%, LMT 28%, FBM 21% and OXC in 10%. Conclusion: New anticonvulsant drugs are an important tool in the treatment of refractory epilepsy. In our country the main reasons for drugs withdrawal were economic, side effects, lack of efficacy or tolerance.
15-l 7-l 5 ] Lamotrigine
Patlents and Method: The studied group consisted of 10 subjects (5 male, 5 female) with a mean age of 38.7 years (23-65). The age at onset of absences was 8.6 y. (4-16). All suffered tonic-clonic seizures which begun at 16.9 y. (4-60). We recorded on the EEG typical absences in all the patients. 10 were treated with VPA and 7 with VPA+ESM. In spite of this treatment they continued to suffer frequent absences. The addition of LTG produced a complete control of absences in 4 (40%) and a reduction of >75% in 6 (60%) of the cases. The present treatment, after 24.6 months (10-38) with LTG, is the following: LTG: 2 cases; LTG+VPA: 7 cases; LTG+Primidone: 1 case. In two patients we tried LTG monotherapy but they required LTG+VPA to achieve a complete control of their seizures. Remarks: LTG is a very useful treatment for persisting absences during adult life. Some patients need the association of LTG and VPA to be seizurefree.
Effects of subcutaneous childhood migraine
sumatriptan
therapy in
Ali Akyol ’ , Bi.ilent Mungen 2, Mehmet Turgut ‘, Saadst Akarsu *, Eralp Bellibas ‘, Kemal Bayiilkem ‘. ’ Adnan Menderes University Hospital, Depts. of NeurolcgH Neurosurgery and Pharmawfog~ Aydm, Turkey; 2 firat University Hospital, Depts. of Neurology; Efazid, Turkey Background and Objectives: It is believed that the pathogenesis of migraine is primarily of vascular origin, the headache being associated with marked and prolonged phase of cranial vasodilatation. Sumatriptan constrict selectively distanded and inflammed cranial vessels by activating of 5HT 1 subtype receptors, durtng migraine attack. We aimed to show the effectiveness of subcutaneous sumatriptan therapy in childhood migraine. There is not enough study about these age group. Method: In this study, 15 children ranging in age from 6-15 years diagnosed as migraine were evaluated for their clinical features. Four patients subcutaneous sumatriptan of 3 mg dose and the others received the subcutaneous application of sumatriptan of 6 mg. Patients comments and adverse effects about the drug were evaluated after three subsequent usage. Results: There were some side-effects such as pain in the injection site and bad taste sensation in some patients. However, severity, frequency and duration of pain decreased in all of patients. Results were evaluated statistically (p < 0.01). Conclusions: We suggest that sumattiptan is an effective agent and tolerable drug during the acute migraine attack in pediatric age group, but we need further studies for the standard dosage in these patients.