1,720,978 research outputs found
Body mass index and serum lipid changes during treatment with valproic acid in children with epilepsy
No full textBACKGROUND: Valproic acid is the drug of choice for a wide variety of epileptic seizures and syndromes because of its broad spectrum of activity and because, in most patients, it is well tolerated. Although weight gain is a well-known adverse effect of valproic acid therapy, only a few studies have addressed weight gain associated with it in children aged 2-8 years.
OBJECTIVE: To evaluate valproic acid-associated changes in the body mass index (BMI) z-scores and to assess changes in serum triglyceride, cholesterol, and fasting glucose levels in young children receiving valproic acid treatment.
METHODS: Eighty-seven patients (39 females, 48 males) receiving valproic acid therapy for at least 3 months were included in the retrospective longitudinal study. Mean +/- SD age at initiation of therapy was 4.8 +/- 0.8 years. Changes in BMI z-scores as well as serum triglyceride, total cholesterol, and fasting glucose levels were evaluated as continuous variables and analyzed by longitudinal methods for all patients.
RESULTS: The average change from baseline in BMI z-scores was 0.80 (p 0.001) at 3.1 years of follow-up. No significant change in triglyceride, cholesterol, and serum fasting glucose levels was observed over the same period. The percentage of overweight children at baseline was 6.9% and rose to 16% by the final visit (p = 0.081).
CONCLUSIONS: Valproic acid-associated weight gain may occur in young children. However, only 16% of patients were categorized as overweight at the end of the study; this percentage overlaps the percentage of overweight healthy young Italian children. The BMI z-scores significantly increased during the first 16 months of therapy, then appeared to level off. These observations may influence clinical practice and decision-making regarding suspending the drug due to weight gain in children in whom seizure control has been achieved
Epilepsy, speech delay, and mental retardation in facioscapulohumeral muscular dystrophy.
No full textFacioscapulohumeral muscular dystrophy (FSHD) is one of the most common muscular dystrophies which is related to the deletion of tandem repeats on chromosome 4q35. Extramuscular features such as hearing loss, retinopathy, mental retardation, and epilepsy, may be observed in patients carrying large 4q35 deletions resulting in fragment sizes less than 12 kilobases (kb) (normal >35 kb). We report on a family affected by FSHD carrying a small 4q35 deletion and residual fragments length of 17 kb, presenting with epilepsy (three patients), speech delay (two), and mental retardation (one). In all patients semeiology of seizures and interictal EEG anomalies were congruent with a localization-related epilepsy possibly involving the temporal lobe. In conclusion, we provide further evidences that extramuscular findings such as epilepsy, speech delay, and mental retardation may occur in those patients carrying smaller 4q35 deletions, suggesting that a close correlation between 4q35 fragment size and clinical severity in FSHD is therefore not constant. Moreover, a review of the literature and our observations seem to suggest that focal epilepsies, likely related to the temporal lobe in the present family, represent the main type of epilepsy occurring in children with FSHD
Inter-ictal and post-ictal circulating levels of allopregnanolone, an anticonvulsant metabolite of progesterone, in epileptic children
No full textAllopregnanolone belongs to a group of neuroactive steroid hormones, or neurosteroids, synthesized and acting within the
brain and is as a potent endogenous positive modulator ofGABAA receptor complex. Administration of allopregnanolone protects
rats against pentylentetrazol, bicuculline, kainic acid, and picrotoxin-induced seizures.
We investigated serum allopregnanolone levels in children with active epilepsy at pubertal Tanner’s stage I (n = 52). Blood
specimens were collected at least 12 h after a seizure (inter-ictal). In a subgroup of patients (n = 11), specimens were also
collected within 30 min from a seizure attack (post-ictal). Healthy age-matched children (n = 18) served as controls. Serum
allopregnanolone was measured by radioimmunoassay using a polyclonal antiserum.
The inter-ictal serum allopregnanolone levels in the epileptic children were not statistically different from those detected in
the control group, whereas post-ictal levels were significantly higher than the inter-ictal ones (P = 0.0001). In this subgroup of
patients allopregnanolone levels decreased to the basal values during the following 12 h.
Serum allopregnanolone levels may therefore reflect changes in neuronal excitability, and allopregnanolone appears to be a
reliable circulating marker of epileptic seizures. It is possible that increased post-ictal serum levels of allopregnanolone may
play a role in modulating neuronal excitability and may represent an endogenous mechanism of seizure control
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Vigabatrin treatment in children
No full textSixty-nine children, aged from 2 months to 16 years and suffering from different types of drug-resistant epileptic seizures, mostly complex partial and secondary generalised, were recruited in an open, uncontrolled, prospective study of treatment with vigabatrin (gamma-vinyl GABA). Following a 3-month baseline observation period, the initial dose of vigabatrin of 10 mg/kg per day was progressively increased up to a maximum of 140 mg/kg per day, in addition to the conventional concomitant therapy. Sixteen patients showed a > or = 50% reduction in seizure frequency compared with the baseline, with complete control of seizures in nine cases. In 14 other patients, no substantial change in seizure frequency was observed, although an improvement in psychological performance after vigabatrin treatment warranted further continuation of the drug. In 35 patients vigabatrin was discontinued because of lack of efficacy (22 cases) and/or increased seizure frequency (13 cases). The clinical and biological tolerance of vigabatrin was remarkably good
Circulating Levels of Allopregnanolone, a Neuroactive Steroid, and Leptin during Treatment with Valproic Acid in Children with Epilepsy
No full textInter-ictal and post-ictal circulating levels of allopregnanolone, an anticonvulsant metabolite of progesterone, in epileptic children
No full textAllopregnanolone belongs to a group of neuroactive steroid hormones, or neurosteroids, synthesized and acting within the brain and is as a potent endogenous positive modulator of GABAA receptor complex. Administration of allopregnanolone protects rats against pentylentetrazol, bicuculline, kainic acid, and picrotoxin-induced seizures. We investigated serum allopregnanolone levels in children with active epilepsy at pubertal Tanner's stage I (n=52). Blood specimens were collected at least 12h after a seizure (inter-ictal). In a subgroup of patients (n=11), specimens were also collected within 30min from a seizure attack (post-ictal). Healthy age-matched children (n=18) served as controls. Serum allopregnanolone was measured by radioimmunoassay using a polyclonal antiserum. The inter-ictal serum allopregnanolone levels in the epileptic children were not statistically different from those detected in the control group, whereas post-ictal levels were significantly higher than the inter-ictal ones (P=0.0001). In this subgroup of patients allopregnanolone levels decreased to the basal values during the following 12h. Serum allopregnanolone levels may therefore reflect changes in neuronal excitability, and allopregnanolone appears to be a reliable circulating marker of epileptic seizures. It is possible that increased post-ictal serum levels of allopregnanolone may play a role in modulating neuronal excitability and may represent an endogenous mechanism of seizure control. © 2003 Elsevier Science B.V. All rights reserved
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