Effects of 4-Aminopyridine in Eaton Lambert Syndrome

Ágoston, S.; Weerden, TW van; Westra, P.; Broekert, A.

doi:10.1093/bja/50.4.383

Cited by 64 publications

(17 citation statements)

References 6 publications

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“…4-Aminopyridine has a long history of clinical use; ®rst to antagonize neuromuscular blockade from various anaesthetics, 22 ± 24,66 then as a therapeutic agent to enhance neural or neuromuscular transmission in patients with Alzheimers disease, 25 botulinum toxicity, 26 myaesthenia gravis 27,28 or Eaton-Lambert Syndrome 21,29 and more recently as a means of overcoming central conduction de®cits due to demyelination in patients with multiple sclerosis. 30 ± 40 Its application in patients with spinal cord injury is even more recent and is still in the investigative stages as the drug's safety and ecacy have yet to be de®nitively established in the SCI population by randomized placebo-controlled, double-blind clinical trials.…”

Section: Discussionmentioning

confidence: 99%

Sustained improvements in neurological function in spinal cord injured patients treated with oral 4-aminopyridine: three cases

et al. 1998

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Preclinical trials of intravenously administered 4-Aminopyridine (4-AP) have demonstrated transient improvements in neurological function in patients with longstanding spinal cord injury (SCI). The present report describes three patients with SCI who responded favourably in preclinical trials and who were subsequently administered oral (capsule) 4-AP (10 mg b.i.d. or t.i.d.) over a 4 month interval. The three patients (two male: 1 female) all had incomplete tetraplegia (ASIA levels C and D) with the neurological level of the lesion between C5-C7. Following the administration of 4-AP the patients demonstrated marked and sustained reductions in upper (n=1) or lower extremity (n=2) spasticity. Other clinical bene®ts of 4-AP were reduced pain (n=1), restored muscle strength (n=3), improved sensation (n=2), voluntary control of bowel function (n=1), and sustained penile tumescence (n=2). The patients exhibited improved hand function (n=1), enhanced mobility in transfers and gait (n=2), with improved energy and endurance. Only trivial side eects (transient lightheadedness) were observed. In one case, the enhanced neurological function allowed the patient to stand with support for the ®rst time post injury (16 years). The time course of therapeutic response to the initial dose matched the pharmacokinetic elimination pro®le derived from serum and urine analysis. There was no evidence of renal or hepatic toxicity with prolonged use. These results indicate a therapeutic bene®t of oral 4-Aminopyridine in the management of various neurological de®cits in a select group of SCI patients.

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Section: Discussionmentioning

confidence: 99%

Sustained improvements in neurological function in spinal cord injured patients treated with oral 4-aminopyridine: three cases

et al. 1998

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“…They are less effective against p-bungarotoxin and taipoxin (HARVEY and MARSHALL 1977b;KAMEN-SKA Y A and THESLEFF 1979), possibly because enhanced Ca 2 + influx produced by aminopyridines not only increases acetylcholine release, but also enhances the opposing actions of the toxins. Aminopyridines improve transmission in the EatonLambert syndrome, which is the result of a prejunctional lesion (LUNDH et al 1977b;AGOSTON et al 1978;SANDERS et al 1980;MURRAY and NEWSON-DAVIS 1981). Further details of its action in this human disease are given in Sect.…”

Section: Repetitive Nerve Stimulationmentioning

confidence: 99%

“…It is often associated with oat cell carcinoma of the lung (EATON and LAMBERT 1957) and may foreshadow neoplastic disease (CHERINGTON 1976). Recently, 4-aminopyridine has been shown to be effective in patients with Eaton-Lambert syndrome (LUNDH et al 1977b;AGOSTON et al 1978;KIM et al 1980b). The drug produces an increase in the indirectly evoked muscle action potentials of as much as 300% after intravenous administration of 0.3-0.6 mg/kg .…”

Section: Experimental Clinical Usementioning

confidence: 99%

4-Aminopyridine Hydrochloride (Pymadin)

Paskov¹,

Ágoston²,

Bowman³

1986

New Neuromuscular Blocking Agents

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“…It enhances transmission at synapses including the neuromuscular junction and is currently approved by the FDA to help improve walking in patients with multiple sclerosis [2]. It has also been used for treating clinical signs associated with Eaton-Lambert syndrome, botulism, and myasthenia gravis [3][4][5]. The medication is available in 10-mg tablets with the brand name of AMPYRA™.…”

Section: Introductionmentioning

confidence: 99%

A Review of 29 Incidents Involving 4-Aminopyridine in Non-target Species Reported to the ASPCA Animal Poison Control Center

McLean

Khan

2013

J. Med. Toxicol.

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4-Aminopyridine (4-AP) is an avicide used in products that are approved by the Environmental Protection Agency (EPA) to control populations of various birds. Pharmaceutical 4-AP is also used in humans to treat neural and muscular dysfunctions associated with multiple sclerosis. Although strict restrictions for its use are in place, exposures to 4-AP bait by non-target species still occur. Twenty-nine exposures of 4-AP bait involving non-target species were identified and retrieved from the ASPCA Animal Poison Control Center medical record database. Canines were the most commonly exposed (86 %) species followed by felines (10 %). The highest frequency of exposures was reported from Colorado (22 %). Most commonly reported clinical signs in canines were tremors, hypersalivation, seizures, tachycardia, and ataxia.

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Effects of 4-Aminopyridine in Eaton Lambert Syndrome

Cited by 64 publications

References 6 publications

Sustained improvements in neurological function in spinal cord injured patients treated with oral 4-aminopyridine: three cases

Sustained improvements in neurological function in spinal cord injured patients treated with oral 4-aminopyridine: three cases

4-Aminopyridine Hydrochloride (Pymadin)

A Review of 29 Incidents Involving 4-Aminopyridine in Non-target Species Reported to the ASPCA Animal Poison Control Center

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