Plasma arginine vasopressin concentrations in epileptics under monotherapy

Krause, Klaus-Henning; Rascher, Wolfgang; Berlit, Peter

doi:10.1007/bf00313630

Cited by 20 publications

(16 citation statements)

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“…It has been demonstrated that the AVP system mediates regional cerebral flow [27], affects brain hydric content and possibly plays a role in generating oedema [28,29]. Several antiepileptic drugs interfere with the AVP system [30]. Carbamazepine may potentiate AVP antidiuretic effects [31, fondamentale nella genesi di tali lesioni, pur riconoscendo che il meccanismo attraverso il quale queste vengono a formarsi è ancora poco chiaro.…”

Section: Discussionunclassified

“…È stato dimostrato che il sistema AVP regola il flusso cerebrale regionale [27], influenza il contenuto di acqua nell'encefalo e può contribuire alla formazione dell'edema [28,29]. Diversi farmaci antiepilettici interagiscono con il sistema AVP [30]. La carbamazepina, infatti, può aumentare l'effetto antidiuretico dell'AVP [31,32].…”

Section: Discussionunclassified

“…The patients, three men and three women, with a mean age of 21 (range [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] years, underwent brain MRI due to suspected infectious brain disease (n=2), venous sinus thrombosis (n=1) and demyelination disease (n=3). Each patient was studied by brain CT and MRI (Shimadzu…”

Section: Methodsmentioning

confidence: 99%

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Transient focal lesion in the splenium of the corpus callosum: MR imaging with an attempt to clinical-physiopathological explanation and review of the literature

et al. 2007

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Section: Discussionunclassified

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Transient focal lesion in the splenium of the corpus callosum: MR imaging with an attempt to clinical-physiopathological explanation and review of the literature

et al. 2007

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“…It has been demonstrated that AVP regulates regional cerebral blood flow,21 influences brain water content, and can contribute to brain oedema formation 22-23. Different AEDs have been shown to interact with AVP 24. Both clinical experience and experimental studies showed that carbamazepine can enhance the antidiuretic effect of AVP 25-27.…”

Section: Discussionmentioning

confidence: 99%

Transient lesion in the splenium of the corpus callosum: three further cases in epileptic patients and a pathophysiological hypothesis

Polster¹,

Hoppe²,

Ebner³

2001

Journal of Neurology, Neurosurgery &Amp; Psychiatry

129

135

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Objective-Focal lesions limited to the splenium of the corpus callosum (SCC) are rare and little is known about their aetiology. Three patients were examined for presurgical evaluation in epilepsy with a transient lesion in the SCC and a pathophysiological hypothesis is presented. Methods-Three patients were identified with a circumscribed lesion in the centre of the corpus callosum. Follow up MRI was performed, the medical records examined retrospectively, and the literature reviewed. Results-The patients showed identical lesions in the SCC with reduced T1 and increased T2 signal intensity and an unaffected marginal hemline of a few mm. Patients were asymptomatic and control MRIs showed complete normalisation within 2 months. Patients had been treated with antiepileptic drugs (AEDs) without signs of toxicity. In all patients AEDs were rapidly reduced for diagnostic purposes, but only one had psychomotor seizures, 5 days before imaging. Conclusions-A transient lesion in the SCC has so far only been described in 13 patients with epilepsy and has been interpreted either as reversible demyelination due to AED toxicity or transient oedema after secondary generalised seizures. The data confirm neither of these hypotheses. A transient lesion in the SCC seems to be a non-specific end point of diVerent disease processes leading to a vasogenic oedema. This suggests, in these patients, a multifactorial pathology triggered by transient eVects of AEDs on arginine vasopressine and its function in fluid balance systems in a condition of vitamin deficiency. The complete and rapid reversibility in all cases without specific intervention is emphasised and any invasive diagnostic or therapeutic approach is discouraged. (J Neurol Neurosurg Psychiatry 2001;70:459-463) Keywords: corpus callosum; anticonvulsant drugs; brain oedema; argipressine Focal imaging abnormalities of the corpus callosum are rare but have been described in various clinical conditions. We have detected a circumscribed lesion confined to the splenium of the corpus callosum in three patients during presurgical evaluation of therapy for refractory epilepsy. An identical lesion has been reported, but the pathophysiological mechanisms have not been identified. [1][2] We have reviewed the literature on splenial lesions and present a new hypothesis about the underlying mechanisms. Case reportsPATIENT 1 A 34 year old woman had an unclassified epilepsy syndrome with partial and generalised During non-invasive monitoring for 10 days she did not show any ictal event and her EEG was normal even though we had stopped phenytoin medication (serum concentration 21.8 mg/l). Brain MRI showed a hypointense signal in the splenium of the corpus callosum on the T1 weighted and inversion recovery scans that was hyperintense in the T2 weighted as well as in FLAIR images (fig 1).These characteristics suggested an abnormally high water content in these areas. The lesion was not associated with further white matter abnormalities and left about 2 mm of the marginal area aroun...

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“…Antiepileptic drugs are known to in‰uence the ‰uid-balance system, i.e., arginine-vasopressin (AVP), 6 whereas the antiepileptic drug, carbamazepine, is shown to potentiate the antidiuretic eŠect of AVP. 7 We present a case of a transient SCC lesion occurring after withdrawal of carbamazepine.…”

Section: Introductionmentioning

confidence: 99%

Transient Splenial Lesion of the Corpus Callosum after Acute Withdrawal of Antiepileptic Drug: A Case Report

et al. 2006

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Transient lesions at the splenium of the corpus callosum (SCC) have been reported after withdrawal of speciˆc antiepileptic drugs (AED), though the pathophysiology of the lesions remains unclear. We examined and treated a schizophrenic patient who developed a transient SCC lesion after withdrawal of the AED, carbamazepine. Interestingly, the SCC lesion was accompanied by the onset of diabetes insipidus, a state of arginine-vasopressin (AVP) insu‹ciency. Because carbamazepine is shown to potentiate the eŠect of AVP, our case suggests that an insu‹ciency of AVP followed by withdrawal of AED could contribute to the pathogenesis of a transient SCC lesion.

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Plasma arginine vasopressin concentrations in epileptics under monotherapy

Cited by 20 publications

References 12 publications

Transient focal lesion in the splenium of the corpus callosum: MR imaging with an attempt to clinical-physiopathological explanation and review of the literature

Transient focal lesion in the splenium of the corpus callosum: MR imaging with an attempt to clinical-physiopathological explanation and review of the literature

Transient lesion in the splenium of the corpus callosum: three further cases in epileptic patients and a pathophysiological hypothesis

Transient Splenial Lesion of the Corpus Callosum after Acute Withdrawal of Antiepileptic Drug: A Case Report

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