Immunofluorescent Evidence for a Specific Binding Site for Phenytoin in the Cerebellum

Hammond, E. J.; Wilder, B. J.

doi:10.1111/j.1528-1157.1983.tb04889.x

Cited by 12 publications

(1 citation statement)

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“…Ablation of the cerebellar vermis and the intermediate zone in cats results in an increase in the spike frequency of penicillininduced cortical lesion (13). Furthermore, there is evidence for a specific PHT-binding site on cerebellar neurons (42), and PHT has been shown to increase firing rates in Purkinje cells (43,44). Therefore, some investigators proposed that the mechanism of action of PHT phenytoin is in part due to an enhancement of cerebellar inhibition of the seizure focus (4,15).…”

Section: Discussionmentioning

confidence: 99%

Cerebellar Changes in Partial Seizures: Clinical Correlations of Quantitative SPECT and MRI Analysis

et al. 1998

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Summary: Purpose: To determine the frequency and patterns of periictal cerebellar hyperperfusion, whether it is associated with increased cerebellar atrophy, and whether cerebellar hyperperfusion and cerebellar atrophy are associated with predisposing clinical factors or with the outcome of epilepsy surgery.Methods: Periictal and interictal SPECT scans and volumetric brain magnetic resonance imaging (MRI) were quantitatively analyzed in 54 consecutive patients with medically refractory partial epilepsy. Their histories were reviewed and their postsurgical outcomes assessed.Results: Significant periictal cerebellar hyperperfusion was found in 26 (48.1%) patients, of whom 18 had CCH, two had homolateral cerebellar hyperperfusion (HCH), and six had symmetrical bilateral hyperperfusion (BCH). No relation found between the site of the SPECT seizure localization and the presence or type of cerebellar hyperperfusion. CCH was more common when the injected seizure involved unilateral clonic motor activity (p < 0.05). A smaller MRI relative cerebellar volume (cerebellar volume/cerebral volume) was correlated with a greater seizure frequency (R, = -0.30; p < 0.05) but not with the duration of epilepsy. There was no difference in the cerebellar volumes between the different patterns of cerebellar perfusion (p > 0.05). However, patients without a focal structural MRI lesion had significantly smaller cerebellar volumes (p < 0.05). In patients who underwent epilepsy surgery (n = 31), there was a trend for those without excellent outcomes to have smaller relative cerebellar volumes than did those with excellent outcome (10.6 vs. 11.8%; p = 0.08).Conclusions: Periictal changes in cerebellar perfusion, particularly CCH, are common in patients with intractable partial epilepsy. However, periictal hyperperfusion does not appear to be a major contributor to the development of cerebellar atrophy.

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Section: Discussionmentioning

confidence: 99%