Renewed corporate interest in the anticonvulsant drug eterobarb justified renewed clinical and experimental interest in this drug. The unique and clinically intriguing feature of eterobarb is that while sharing the anticonvulsant properties of other barbiturates, the hypnotic side effects usually associated with barbiturates appear to be absent in animal studies and greatly reduced in clinical trials. This study was designed to compare the hypnotic effects of eterobarb with those of phenobarbital in healthy normal human volunteers using a double-blind, placebo-controlled design. Both clinical and neuropsychological parameters of toxicity were measured, while blood barbiturate levels were monitored to correlate neurobehavioral changes with total barbiturate level. As expected, there is a linear relationship between the degree of toxicity and the barbiturate level, but much higher barbiturate levels were tolerated without toxicity by subjects taking eterobarb. For ethical reasons, subjects were not maintained at high levels of toxicity over the 14-week trial. However, both eterobarb and phenobarbital recipients failed to show significant improved performance on Digits Total, a test of mental flexibility (Digit Symbol Substitution). In addition, phenobarbital recipients showed the only significant decrement of performance on Digits Total, and they failed to improve significantly on Trails-Part A, in which all other groups improved. This study confirms that eterobarb has less hypnotic side effects and less neurotoxicity than does phenobarbital.

Adolescent↗

PubMedDate not supplied

Behavioral characteristics of epilepsy patients compared with normal controls.

Using neuropsychological testing procedures, we measured the behavioral characteristics of patients with epilepsy unaffected by anticonvulsant drugs and compared these results with control subjects matched for age, sex, and education. In a nationwide VA Cooperative study, 622 patients with well-defined seizure types were given a selected battery of neuropsychological tests prior to and at 1 month after initiation of drug therapy. Seventy-four control subjects were administered the same test battery under standardized conditions at the same VA testing centers. All tests of controls were also repeated 1 month later. The patients with epilepsy scored significantly and consistently below the level of the control subjects on all but three behavioral measures. Differences reaching statistical significance were found on tests of motor function (Finger Tapping, Pegboard, Color Naming), cognitive-attention (Digit Symbol, Discriminative Reaction Time, Word Fluency), and subtests of the Profile of Mood Status (tension, depression, vigor, and confusion). These data provide a profile of behavioral characteristics of unmedicated patients with epilepsy.

Adolescent↗

PubMedDate not supplied

Epilepsy education in medical schools: report of the American Epilepsy Society Committee on Medical Student Education.

The education of medical students about epilepsy is often fragmentary and incomplete. Basic information regarding the classification of epileptic seizures, epilepsy syndromes, first aid for seizures, and practical use of antiepileptic drugs (AEDs) may not be covered in medical school curricula. In this report we describe reasons why the study of epilepsy provides a relatively unique opportunity to integrate concepts related to basic neuroscience and clinical neurology. Furthermore, we present a curricular framework that may prove useful for the education of medical students about epilepsy.

Anticonvulsants↗

PubMedDate not supplied

Partially successful treatment of Rasmussen's encephalitis with zidovudine: symptomatic improvement followed by involvement of the contralateral hemisphere.

An 18-year-old woman with a 4-year history of Rasmussen's encephalitis (RE) manifested by progressive aphasia, right hemiparesis, and nearly continuous intractable simple partial seizures that frequently secondarily generalized was treated with zidovudine (AZT). Seizures had not responded to any of the major antiepileptic drugs (AEDs) administered to high and toxic levels, or to ACTH. AZT was given for 62 days and discontinued because of granulocytopenia. Within 6 weeks of AZT initiation, seizure stopped and neurologic deterioration was arrested for approximately 21 months. Subsequently, partial somatomotor seizures developed, affecting the previously uninvolved left hemibody. A 2-week repeat course of AZT was attempted, but unremitting fever and gastrointestinal (GI) side effects precluded continuation of AZT treatment. Spontaneous, sustained remission of seizures has not been reported in untreated RE. Seizure control and arrest of neurologic deterioration in this case outlasted use of AZT by 19 months. Because of the apparent response of this patient to AZT, clinical studies designed to assess long-term palliative/curative properties of antiviral agents, particularly in patients with involvement of the hemisphere dominant for language, appear warranted.

Adolescent↗

PubMedDate not supplied

Demyelinating disease presenting as Wallenberg's syndrome. Report of a patient.

Explore the source record for details and available documents.

Brain↗

PubMedDate not supplied

Physostigmine reversal of sedation in parturients.

Parturients in whom meperidine HCl, propiomazine HCl, and scopolamine were used for analgesia and amnesia in labor and delivery were studied to determine the efficacy and safety of physostigmine reversal after delivery. Of a total of 120 patients, 108 received physostigmine salicylate at the completion of episiotomy closure, awakening in an average of 7.5 minutes compared with 137.8 in 12 controls. Physostigmine appears to be a safe, rapidly effective agent for reversing the prolonged somnolence of this sedation regimen.

Adult↗

PubMedDate not supplied

Sexual rehabilitation of urologic cancer patients: a practical approach.

Sexual rehabilitation is an important aspect of preserving a patient's quality of life after treatment for urogenital cancer. Sexual rehabilitation does not usually require a specialized program, but can be an integral part of cancer treatment. Members of the health care team can provide sexual information for the patient and partner, as well as assess the need for more intensive marital or sex therapy. This paper presents specific sexual issues related to prostate, bladder, testicular, and penile cancers.

Female↗