scholarly journals ABCB1 Polymorphisms and Drug-Resistant Epilepsy in a Tunisian Population

2019 ◽  
Vol 2019 ◽  
pp. 1-16
Author(s):  
Malek Chouchi ◽  
Hedia Klaa ◽  
Ilhem Ben-Youssef Turki ◽  
Lamia Hila
Keyword(s):  
Treatment Response ◽  
Antiepileptic Drugs ◽  
Gene Polymorphisms ◽  
Tunisian Population ◽  
Drug Resistant ◽  
Population Genetic Analysis ◽  
Interindividual Variations ◽  
Treatment Failure Rate ◽  
Epileptic Patients ◽  
Drug Resistant Epilepsy

Background. Epilepsy is one of the most common neurological disorders with about 30% treatment failure rate. An interindividual variations in efficacy of antiepileptic drugs (AEDs) make the treatment of epilepsy challenging, which can be attributed to genetic factors such as ATP-Binding Cassette sub-family B, member1 (ABCB1) gene polymorphisms. Objective. The main objective of the present study is to evaluate the association of ABCB1 C1236T, G2677T, and C3435T polymorphisms with treatment response among Tunisian epileptic patients. Materials and Methods. One hundred epileptic patients, originated from north of Tunisia, were recruited and categorized into 50 drug-resistant and 50 drug-responsive patients treated with antiepileptic drugs (AEDs) as per the International League Against Epilepsy. DNA of patients was extracted and ABCB1 gene polymorphisms studied using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Results. The C1236T, G2677T, and C3435T polymorphisms were involved into AED resistance. Significant genotypic (C1236T TT (p≤0.001); G2677T TT (p=0.001); C3435T TT (p≤0.001)) and allelic associations (C1236T T (3.650, p≤0.001); G2677TT (1.801, p=0.044); C3435T T (4.730, p≤0.001)) with drug resistance epilepsy (DRE) were observed. A significant level of linkage disequilibrium (LD) was also noted between ABCB1 polymorphisms. Patients with the haplotypes CT and TT (C1236T-G2677T); GT, TC, and TT (G2677T-C3435T); CT and TT (C1236T-C3435T); CTT, TTC, TGT, and TTT (C1236T-G2677T-C3435T) were also significantly associated to AED resistance. Conclusions. The response to antiepileptics seems to be modulated by TT genotypes, T alleles, and the predicted haplotypes for the tested SNPs in our population. Genetic analysis is a valuable tool for predicting treatment response and thus will contribute to personalized medicine for Tunisian epileptic patients.

scholarly journals Effect and Safety of Shihogyejitang for Drug Resistant Childhood Epilepsy

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Jinsoo Lee ◽  
Kwanghyun Son ◽  
Gwiseo Hwang ◽  
Moonju Kim
Keyword(s):  
Adverse Events ◽  
Antiepileptic Drugs ◽  
Retention Rate ◽  
Seizure Type ◽  
Drug Resistant ◽  
Exact Test ◽  
Alternative Treatment Option ◽  
Drug Resistant Epilepsy ◽  
Intent To Treat ◽  
Patients With Epilepsy

Objective. Herbal medicine has been widely used to treat drug resistant epilepsy. Shihogyejitang (SGT) has been commonly used to treat epilepsy. We investigated the effect and safety of SGT in children with drug resistant epilepsy.Design. We reviewed medical records of 54 patients with epilepsy, who failed to respond to at least two antiepileptic drugs and have been treated with SGT between April 2006 and June 2014 at the Department of Pediatric Neurology, I-Tomato Hospital, Korea. Effect was measured by the response rate, seizure-free rate, and retention rate at six months. We also checked adverse events, change in antiepileptic drugs use, and the variables related to the outcome.Results. Intent-to-treat analysis showed that, after six months, 44.4% showed a >50% seizure reduction, 24.1% including seizure-free, respectively, and 53.7% remained on SGT. Two adverse events were reported, mild skin rash and fever. Focal seizure type presented significantly more positive responses when compared with other seizure types at six months (p=0.0284, Fisher’s exact test).Conclusion. SGT is an effective treatment with excellent tolerability for drug resistant epilepsy patients. Our data provide evidence that SGT may be used as alternative treatment option when antiepileptic drug does not work in epilepsy children.

scholarly journals Network meta-analysis of antiepileptic drugs in focal drug-resistant epilepsy

2020 ◽  
Vol 167 ◽  
pp. 106433
Author(s):  
Tong Yao Hu ◽  
Hai-Qiang Wang ◽  
Wen Ping Zhang ◽  
Ruo Fei Tian ◽  
Ge Sheng Lei ◽  
...  
Keyword(s):  
Antiepileptic Drugs ◽  
Meta Analysis ◽  
Drug Resistant ◽  
Drug Resistant Epilepsy

Role of glyoxalase I gene polymorphisms in late-onset epilepsy and drug-resistant epilepsy

2016 ◽  
Vol 363 ◽  
pp. 200-206 ◽  
Author(s):  
Hua Tao ◽  
Ligang Si ◽  
Xu Zhou ◽  
Zhou Liu ◽  
Zhonghua MA ◽  
...  
Keyword(s):  
Gene Polymorphisms ◽  
Late Onset ◽  
Glyoxalase I ◽  
Drug Resistant ◽  
Drug Resistant Epilepsy ◽  
I Gene

scholarly journals DRUG-RESISTANT EPILEPSY IN CASE OF CRANIOCEREBRAL DISPROPORTION. A PILOT STUDY

2021 ◽  
Vol 83 (3) ◽  
pp. 19-23
Author(s):  
Oleg Biketov
Keyword(s):  
Drug Resistance ◽  
Drug Therapy ◽  
Pilot Study ◽  
Antiepileptic Drugs ◽  
Pathological Process ◽  
Research Trends ◽  
Drug Resistant ◽  
The Past ◽  
Craniocerebral Disproportion ◽  
Drug Resistant Epilepsy

The problem of ineff ective drug therapy of epilepsy continues to be relevant during many decades and determines many key research trends in clinical and fundamental epileptology. Despite the emergence of a large number of various antiepileptic drugs the eff ectiveness of drug therapy for epilepsy has remained almost unchanged over the past decades. In this article drug-resistance in epilepsy is considered as a consequence of a concomitant pathological process in the form of craniocerebral disproportion.

FACTORS PROVOKING EPILEPTIC SEIZURES

2021 ◽  
pp. 52-59
Author(s):  
Tokareva N.G. ◽  
Ignatieva O.I.
Keyword(s):  
Antiepileptic Drugs ◽  
Anticonvulsant Drug ◽  
Epileptic Seizures ◽  
Epileptic Activity ◽  
International Standards ◽  
Lower Percentage ◽  
Drug Resistant ◽  
Therapy Regimen ◽  
First Choice ◽  
Drug Resistant Epilepsy

Currently, the most significant problems of adherence to modern pharmacotherapy have been identified. The urgency of the treatment of epilepsy is confirmed by its frequency of spread. In Russian neurology, epilepsy is treated in accordance with international standards and recommendations. For a number of years, the drugs of the first stage of choice have proven their effectiveness. Monotherapy is preferred; with the development of drug-resistant epilepsy, the possibilities of using a combination of antiepileptic drugs are considered. Epileptic activity in the form of increased seizure frequency can be triggered by alcohol consumption, sleep disturbance - wakefulness, stressful situations, eye strain, somatic diseases and other factors. The aim of this study was to determine the main factors of provocation leading to an increase in the frequency of seizures in epilepsy. Materials and methods: we carried out a retrospective analysis of 43 case histories of patients with increased seizure rates who were hospitalized in the neurological department of one of the central clinical hospitals in Saransk. The initiation of anticonvulsant drug therapy in all patients coincided with the justification of the diagnosis. Seizure remission was achieved in the first year of treatment in most patients, which indicates a good level of compliance and coincides with clinical guidelines. Most patients in the sample received monotherapy with antiepileptic drugs of the first choice. An increase in seizures in patients taking antiepileptic drugs was noted at 3 years of treatment. Results: the most frequent factor provoking seizures was non-adherence to the therapy regimen, which was often mistakenly interpreted by outpatient doctors as the development of drug-resistant epilepsy; patients were referred to inpatient treatment for alternative monotherapy or combination therapy. Non-compliance with the therapy regimen was noted in the form of a decrease in the dose of the drug, irregularity of administration, and forgetfulness of the patient. Other factors provoking an increase in the frequency of epileptic seizures accounted for a significantly lower percentage and did not have a relevant significance

scholarly journals The Association Between STX1B Polymorphisms and Treatment Response in Patients With Epilepsy

2021 ◽  
Vol 12 ◽  
Author(s):  
Shitao Wang ◽  
Liang Zhou ◽  
Chenglu He ◽  
Dan Wang ◽  
Xuemei Cai ◽  
...  
Keyword(s):  
Quantitative Trait Loci ◽  
Treatment Response ◽  
Quantitative Trait ◽  
Expression Quantitative Trait Loci ◽  
Drug Resistant ◽  
Dominant Model ◽  
Bonferroni Correction ◽  
Gender And Age ◽  
Drug Resistant Epilepsy ◽  
Patients With Epilepsy

Background: Epilepsy is a debilitating brain disease with complex inheritance and frequent treatment resistance. However, the role of STX1B single nucleotide polymorphisms (SNPs) in epilepsy treatment remains unknown.Objective: This study aimed to explore the genetic association of STX1B SNPs with treatment response in patients with epilepsy in a Han Chinese population.Methods: We first examined the associations between STX1B SNPs and epilepsy in 1000 Han Chinese and the associations between STX1B SNPs and drug-resistant epilepsy in 450 subjects. Expression quantitative trait loci analysis was then conducted using 16 drug-resistant epileptic brain tissue samples and results from the BrainCloud database (http://eqtl.brainseq.org).Results: The allelic frequencies of rs140820592 were different between the epilepsy and control groups (p = 0.002) after Bonferroni correction. The rs140820592 was associated with significantly lower epilepsy risk among 1,000 subjects in the dominant model after adjusting for gender and age and Bonferroni correction (OR = 0.542, 95%CI = 0.358–0.819, p = 0.004). The rs140820592 also conferred significantly lower risk of drug-resistant epilepsy among 450 subjects using the same dominant model after adjusting for gender and age and Bonferroni correction (OR = 0.260, 95%CI = 0.103–0.653, p = 0.004). Expression quantitative trait loci analysis revealed that rs140820592 was associated with STX1B expression level in drug-resistant epileptic brain tissues (p = 0.012), and this result was further verified in the BrainCloud database (http://eqtl.brainseq.org) (p = 2.3214 × 10–5).Conclusion: The STX1B rs140820592 may influence the risks of epilepsy and drug-resistant epilepsy by regulating STX1B expression in brain tissues.

scholarly journals Evaluation of the effectiveness of electroconvulsive therapy in the treatment of psychosis in a patient with epilepsy. Clinical case

2021 ◽  
Vol 13 (1S) ◽  
pp. 79-87
Author(s):  
T. V. Dokukina ◽  
F. P. Khlebokazov ◽  
I. I. Khvostova ◽  
N. N. Misyuk ◽  
K. A. Bondar ◽  
...  
Keyword(s):  
Drug Treatment ◽  
Antiepileptic Drugs ◽  
Electroconvulsive Therapy ◽  
Successful Treatment ◽  
Clinical Condition ◽  
Clinical Case ◽  
Epileptic Seizures ◽  
Drug Resistant ◽  
Drug Resistant Epilepsy ◽  
Progressive Course

The results of successful treatment of schizophrenic psychosis with persistent catatonic symptoms, refusal to eat in a patient with epilepsy are presented. In view of the progressive course of the disease, the lack of dynamics from the ongoing drug treatment, the method of electroconvulsive therapy was applied. Epileptic seizures and visual signs of brain epileptization were absent with the development of psychosis. As a result of the course of electroconvulsive therapy (9 procedures), the patient's clinical condition improved significantly. This observation illustrates the possibility of using electroconvulsive therapy in combination with antipsychotics and antiepileptic drugs as an alternative method for treating drug-resistant epilepsy.

scholarly journals Pathogenesis of drug resistant epilepsy

2019 ◽  
Vol 11 (1) ◽  
pp. 79-87
Author(s):  
S. M. Malyshev ◽  
T. M. Alekseeva ◽  
W. A. Khachatryan ◽  
M. M. Galagudza
Keyword(s):  
Drug Resistance ◽  
Antiepileptic Drugs ◽  
Mechanisms Of Action ◽  
Drug Resistant ◽  
Line Treatment ◽  
First Line ◽  
Receptor Proteins ◽  
Per Se ◽  
Drug Resistant Epilepsy ◽  
First Line Treatment

Pharmacotherapy is the first-line treatment modality for epilepsy. However, in 20-40% of patients, epilepsy is resistant to pharmacotherapy. These numbers have not changed for decades despite the development and use of antiepileptic drugs with novel mechanisms of action. Drug-resistant epilepsy is now considered a separate pathophysiologic and clinical entity. The existing hypotheses on its pathogenesis could be divided in two groups. Firstly, drug-resistance might be caused by an abnormal pharmacokinetics or pharmacodynamics of antiepileptic drugs as a result of congenital or acquired dysfunction of the transporter or receptor proteins. Secondly, it might be a consequence of inherent features of epilepsy per se, such as the so-called “intrinsic severity” or some disorder of the connectome. Taking into account the complexity of this phenomenon, the issue of drug resistance continues to remain in the focus of the current research efforts.

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