The efficacy and safety of oral vigabatrin (VGB) as add-on therapy in the long-term treatment of poorly controlled epilepsy were evaluated in 19 patients with complex partial seizures, either with or without secondary generalization. The study was run with a single-blind, placebo-controlled, crossover design, and included 2 months of placebo and 13-15 months of treatment with VGB, at doses ranging from 1 to 4 g/day. Of the 14 patients who completed the trial, 2 were seizure free, in 5 seizure frequency dropped by more than 75% and in another 5 by more than 50% with respect to baseline. The decrease in seizure frequency in the group as a whole was significant at all observation points of the trial. Three patients were not entered into the long-term phase due to lack of improvement (an increase in seizure frequency was observed in one of them), and 2 were excluded later because improvement disappeared leading to unauthorized changes in comedication. Side effects were mild and never caused discontinuation of treatment. In conclusion, VGB showed a remarkable efficacy and safety in the long-term treatment of complex partial seizures.

Administration, Oral↗

PubMedDate not supplied

Liposome-entrapped gamma-aminobutyric acid inhibits isoniazid-induced epileptogenic activity in rats.

Sprague-Dawley rats with interictal and ictal spike activity induced by intraperitoneally injected isoniazid (INH) were treated, 5 min before or 30 min later, with liposome-entrapped gamma-aminobutyric acid (GABA) (LEG) or GABA or phosphatidylserine. Crossover injections were given in random sequence and INH alone ws also injected in every animal as a control. LEG inhibited either seizures or interictal spikes in both groups. No decrease of epileptogenic activity was seen after GABA or phosphatidylserine treatment alone. It is suggested that LEG could contribute to the reconstitution of the GABA pool decreased by INH.

Animals↗

PubMedDate not supplied

Internal borderzone infarction in patients with ischemic stroke.

OBJECTIVE: The mechanism underlying cerebral infarction in the borderzone between the territories of deep and superficial perforating arteries has not yet been clarified. This study was performed to investigate the prevalence, volume, site, and etiology of this type of subcortical infarction in a large unselected group of stroke patients. METHODS AND PATIENTS: We analyzed a continuous series of 383 patients with recent cerebral infarction observed in our Stroke Unit. Patients underwent a complete clinical and instrumental workup. The subgroup of subjects with internal borderzone infarct alone were compared with the subgroups of patients with other types of cerebral infarcts by uni- and multivariate statistical tests. RESULTS: There were 90 internal borderzone infarcts of 725 ischemic lesions (12%of the total), with a median volume of 0.32 ml (95% confidence interval 0.24-0.44; range: 0.012- 20.2 ml). Internal borderzone infarcts alone occurred in only 13 of 383 (3.4%) patients. A comparison between patients with 'pure' internal borderzone infarction and patients with other types of cerebral infarcts by multiple logistic regression analysis demonstrated a significant independent causal role of carotid stenosis or occlusion. CONCLUSION: Our study suggests that 'pure' internal borderzone infarctions are quite rare findings in patients with ischemic stroke, and that the hemodynamic impairment due to atherosclerotic occlusion or stenosis of the carotid system could be the cause in the large majority of cases.

Aged↗

PubMedDate not supplied

Diagnostic evaluation of degenerative and vascular dementia.

The accuracy of the Ischemic Score (IS) of Hachinski in the differential diagnosis between senile dementia (SDAT) and multi-infarct dementia (MID) is evaluated in this study. Ninety-four demented patients were subdivided on the basis of CT scan in three subgroups: 1) CT-SDAT (ventricular enlargement and widening of cortical sulci), 2) CT-MID (multiple low density areas attributable to ischemic lesions), 3) CT-VASC (single low density area attributable to ischemic lesion). Sixty-nine percent of patients with SDAT and 94% of patients with MID had an Ischemic Score in agreement with the diagnosis established by CT scan. With the purpose of improving the accuracy of the I.S., a modified ischemic score consisting of five items (abrupt onset; history of strokes; focal symptoms; focal signs; focal (single or multiple) CT-low density areas) is proposed as a useful tool in the differential diagnosis between SDAT and MID.

Aged↗

PubMedDate not supplied

A proposal for the clinical classification of acute coma due to organic cerebral lesions.

The purpose of this paper is to propose a preliminary scheme which standardizes the terminology and the manner of classifying comatose states due to organic cerebral lesions. This attempt is based on recognition of the need to use a common language in order to facilitate the transmission of information in this field.

Acute Disease↗