scholarly journals microRNA‐139‐5p confers sensitivity to antiepileptic drugs in refractory epilepsy by inhibition of MRP1

2020 ◽  
Vol 26 (4) ◽  
pp. 465-474 ◽  
Author(s):  
Li Wang ◽  
Lifang Song ◽  
Xiaoyi Chen ◽  
Junfang Suo ◽  
Yanli Ma ◽  
...  
Keyword(s):  
Antiepileptic Drugs ◽  
Refractory Epilepsy

Effect of Neuroinflammation on ABC Transporters: Possible Contribution to Refractory Epilepsy

2018 ◽  
Vol 17 (10) ◽  
pp. 728-735 ◽  
Author(s):  
Xiaolin Deng ◽  
Yangmei Xie ◽  
Yinghui Chen
Keyword(s):  
Antiepileptic Drugs ◽  
Abc Transporters ◽  
Refractory Epilepsy ◽  
Vascular Endothelial Cells ◽  
Efflux Transporters ◽  
Vascular Endothelial ◽  
Intracellular Signalling Pathways ◽  
The Brain ◽  
Transporter Expression

Background & Objective: Epilepsy is a common and serious chronic neurological disorder that is mainly treated with antiepileptic drugs. Although current antiepileptic drugs used in clinical practice have advanced to the third generation, approximately one-third of patients are refractory to these treatments. More efficacious treatments for refractory epilepsy are therefore needed. A better understanding of the mechanism underlying refractory epilepsy is likely to facilitate the development of a more effective therapy. The abnormal expression and/or dysfunction of efflux transporters, particularly ABC transporters, might contribute to certain cases of refractory epilepsy. Inflammation in the brain has recently been shown to regulate the expression and/or function of ABC transporters in the cerebral vascular endothelial cells and glia of the blood-brain barrier by activating intracellular signalling pathways. Conclusion: Therefore, in this review, we will briefly summarize recent research advances regarding the possible role of neuroinflammation in regulating ABC transporter expression in epilepsy.

scholarly journals First, do no harm: the risks of overtreating children with epilepsy

2007 ◽  
Vol 65 (1) ◽  
pp. 1-4 ◽  
Author(s):  
Eunice Chuang ◽  
Marilisa M. Guerreiro ◽  
Sara Y. Tsuchie ◽  
Angelica Santucci ◽  
Carlos A. M. Guerreiro ◽  
...  
Keyword(s):  
Adverse Events ◽  
Prospective Study ◽  
Antiepileptic Drug ◽  
Antiepileptic Drugs ◽  
Seizure Frequency ◽  
Seizure Control ◽  
Control Method ◽  
Refractory Epilepsy ◽  
Do No Harm ◽  
A Prospective Study

BACKGROUND: Although overtreatment with antiepileptic drugs contributes to the morbidity associated with epilepsy, many children still are overtreated. OBJECTIVE: To evaluate if the withdrawal of at least one antiepileptic drug (AED) in children with refractory epilepsy using polytherapy enable a better seizure control. METHOD: This was a prospective study. Children with refractory epilepsy using at least two AEDs were included. Once the patient, or guardian, agreed to participate in the study, one or more AED were slowly tapered off. The remaining AEDs dosages could be adjusted as needed, but a new AED could not be introduced. RESULTS: Fifteen patients were evaluated, three girls; ages ranging from 3 to 18 (mean=8.7 years). After at least one AED withdrawal, two (13.5%) patients became seizure free, seizures improved >50% in 5 (33.5%) patients, did not change in 5 (33.5%), and seizure frequency became worse in 3 (20%). Adverse events improved in 12 patients (80%). CONCLUSION: The withdrawal of at least one AED is a valuable option in the treatment of selected children with refractory epilepsy.

scholarly journals Effect of reduction of antiepileptic drugs in patients with drug-refractory epilepsy

Seizure ◽  
2015 ◽  
Vol 27 ◽  
pp. 25-29 ◽  
Author(s):  
Deepa Dash ◽  
Vikas Aggarwal ◽  
Rupa Joshi ◽  
Madakasira Vasantha Padma ◽  
Manjari Tripathi
Keyword(s):  
Antiepileptic Drugs ◽  
Refractory Epilepsy ◽  
Drug Refractory Epilepsy

Several New Diverse Anticonvulsant Agents Discovered in a Virtual Screening Campaign Aimed at Novel Antiepileptic Drugs to Treat Refractory Epilepsy

2012 ◽  
Vol 52 (12) ◽  
pp. 3325-3330 ◽  
Author(s):  
Mauricio E. Di Ianni ◽  
Andrea V. Enrique ◽  
Pablo H. Palestro ◽  
Luciana Gavernet ◽  
Alan Talevi ◽  
...  
Keyword(s):  
Virtual Screening ◽  
Antiepileptic Drugs ◽  
Refractory Epilepsy ◽  
Anticonvulsant Agents

scholarly journals Comparative study of Pre and Post-operative Drug Costs in Patients with Refractory Epilepsy Undergoing Hemispherectomy and Temporal Lobectomy at the National Children’s Hospital Dr. Carlos Sáenz Herrera

2020 ◽  
pp. 1-3
Author(s):  
Juan L Segura Masís ◽  
◽  
Rodrigo Masís Mejías ◽  
Katherine Alfaro Navas ◽  
Santiago Rodríguez Picado ◽  
...  
Keyword(s):  
Antiepileptic Drugs ◽  
Surgical Procedures ◽  
Refractory Epilepsy ◽  
Epileptic Seizures ◽  
Clinical Results ◽  
Temporal Lobectomy ◽  
Surgical Interventions ◽  
Children's Hospital ◽  
Before And After ◽  
Children’S Hospital

Introduction: Refractory epilepsy can be defined as a failure of adequate trials of antiepileptic drug programs tolerated and appropriately chosen and used (either as monotherapy or in combination) to achieve sustained freedom from seizures. Surgical procedures for the control of epileptic seizures have spread throughout the world, however, large medical centers have mainly focused on studying and analyzing the clinical results of their surgical interventions. For this reason, this study aims to analyze the cost of pre and post-surgical anticonvulsant medications in patients. Objective: To analyze the relationship between preoperative cost / postoperative cost of antiepileptic drugs in patients undergoing hemispherectomy or temporary lobectomy at the National Children’s Hospital (Hospital Nacional de Niños-HNN). Materials and methods: This study is a retrospective, descriptive, quantitative and longitudinal type of a series of patients who were operated in the Epilepsy Monitoring and Surgery Unit (UMCE) of Costa Rica, between November 2000 and December 2018. Information on the history of medications is obtained from patients before and after having undergone hemispherectomy or temporal lobectomy to assess whether or not there is an economic saving in this aspect when comparing both periods of time. Results: 69 patients have undergone hemispherectomy and temporal lobectomy since the creation of the UMCE in November 2000. Of these, 18 (26%) underwent hemispherectomy and 51 (74%) underwent temporary lobectomy. A sample of 31 patients (45%) were obtained, which met the inclusion criteria. The average age of initiation of treatment at the HNN was 5.5 years old (66 months) and the average age at which they underwent surgery was 10.8 years old (130 months). There was one patient in the sample who received 9 anticonvulsant medications before undergoing the surgical procedure and the average number of medications used pre-surgically was 4.45 anticovulsivants per patient. The average postoperative medication was 2.35 anticonvulsivants per patient. The average monthly preoperative cost was $50.17, while the postoperative period was $31.26, with a difference of $18.91. A total of 9 patients in the sample increased the monthly postoperative cost. The total savings per month in the patients included in the sample was $586.36 and extrapolated to the population of 69 patients resulting in a saving of $1,305.14 per month. The projection according to the life expectancy of the patients in the sample translates into a saving of $409,188.59 while the projection to the 69 patients would result in a saving of $910,774.60 for the Caja Costarricense del Seguro Social (CCSS - Costa Rican Social Security Fund). Discussion: The effectiveness of these two surgeries in suitably selected patients is reflected in the economic savings represented by antiepileptic drugs administered after these surgical procedures. Conclusion: we consider that in this center the patients who have been operated have meant a saving for the Caja Costarricense del Seguro Social (CCSS) since they have diminished or completely eliminated the anti-epileptic medical treatment

scholarly journals Barbiturate-refractory epilepsy: safe schedule for therapeutic substitution

1986 ◽  
Vol 44 (3) ◽  
pp. 225-231 ◽  
Author(s):  
Ana Maria Gorz ◽  
Carlos E. S. Silvado ◽  
Paulo Rogério M. Bittencourt
Keyword(s):  
Chronic Disease ◽  
Antiepileptic Drug ◽  
Antiepileptic Drugs ◽  
Third World ◽  
Refractory Epilepsy ◽  
Serum Concentrations ◽  
Partial Seizures ◽  
First Line ◽  
Therapeutic Substitution ◽  
First Choice

Barbiturates are considered first line antiepileptic drugs in third world countries due to traditional and economic reasons. This prospective uncontrolled study of 52 patients aged 15 to 64 years (mean 24) demonstrates that patients who become refractory to barbiturates are mainly those with partial seizures with or without generalization or with a focal EEG abnormality (71%). Seizures tend to become refractory approximately 6 years after barbiturates were started. Progressive barbiturate withdrawal over a period of two to 8 months (mean 5) with institution of treatment with carbamazepine, phenytoin or sodium valproate allowed complete barbiturate withdrawal in 42 of the 52 patients (81%). Furthermore monthly seizure frequency in those in whom barbiturates were withdrawn decreased from 7.1 to 1.7 per patient. An improvement in mental status was observed but not measured. These results show that barbiturates should not be first-choice drugs in patients who have a chronic disease such as epilepsy, and indicate a schedule for barbiturate withdrawal Which is safe and independent of hospitalization or monitoring of antiepileptic drug serum concentrations.

scholarly journals Medicinal plants with anticonvulsant activities with emphasis on their mechanisms of action

2021 ◽  
Vol 1 (2) ◽  
pp. 177-189
Author(s):  
Ali Esmail Al-Snafi
Keyword(s):  
Side Effects ◽  
Medicinal Plants ◽  
Antiepileptic Drugs ◽  
Mode Of Action ◽  
Refractory Epilepsy ◽  
Mechanisms Of Action ◽  
Active Ingredients ◽  
Antiepileptic Activity ◽  
Limited Efficacy ◽  
Anticonvulsant Activities

A large percent of the patients were controlled by the available antiepileptic drugs. The limited efficacy of antiepileptic drugs is still a matter of concern, >30% of patients showed refractory epilepsy and 30-40% suffered from antiepileptic side effects. Many kinds of medicinal plants possessed antiepileptic activity, and many researchers have focused on the efficacy of their crude extracts. This review discussed the medicinal plants with antiepileptic effect focusing on active ingredients and their mode of action.

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