Quantative eeg characteristics of periodic lateralized epileptiform discharges according to benzodiazepine responsiveness

Abstract

Background: Topiramate shows excellent reduction in seizure rate and minimal adverse events. However, there is a significant difference about the optimal dose, duration of topiramate management. Thus, we conduct the multi-center retrospective survey to examine the practical using patterns of topiramate in the neurosurgical patients.Objective: This study is to investigate the actual using patterns and clinical effects of topiramate in patients with neurosurgical disease as antiepileptic drugs (AEDs) in 94 korean multi-centers. Patients and methods: A total of 7,152 patients who had taken topiramate for at least 3 months between August 2008 and February 2009 were eligible to participate in this study. We evaluated demographic data, primary diseases, duration of topiramate administration, initial and subsequent dosage adjustment, concomitant AEDs, the frequency of seizure reduction, and adverse events. Results: Topiramate was most commonly prescribed in stroke (38%), and the mean initial dosage was 65 mg/day, and the mean maintenance dosage was 105 mg/day. The mean duration of the initial dosage for topiramate administration was 24 days, and the mean duration of the maintenance dosage was 125 days, respectively. Among groups with prophylactic administration, 98% did not develop convulsion and among groups with therapeutic administration, 2% was ineffective to control seizure. After taking topiramate, 2% patients showed adverse events, that sensory aberration was the most common. Conclusion: These results suggest that topiramate prescribe widely in diverse neurosurgical disorders, and effective in reduction of seizure frequency, and does not cause serious adverse effects comparable with old AEDs.Purpose: To demonstrate demographics of patients with new onset transient loss of consciousness (TLOC) and clinical characteristics useful in distinguishing causes of TLOC. Methods: We retrospectively enrolled 158 patients aged ≥18 years who visited the emergency rooms of 5 tertiary referral hospitals because of new onset TLOC. Clinical characteristics including symptoms, concurrent medical conditions, comorbidities, and laboratory findings were investigated. Calgary Syncope Seizure Score (CSSS) was measured according to medical records. Results: Among 158 patients, 80 (50.6) were diagnosed as syncope and 62 (39.2%) as epileptic seizures. Tongue biting, head turning, unresponsiveness, unusual posturing and jerking limbs during the TLOC, emotional stress before the TLOC, and no memory of a spell and confusion after the TLOC were associated with epileptic seizures. Lightheadedness, sweating, micturition, and prolonged standing or sitting before the TLOC were associated with syncope. Past history of cerebrovascular disease, concurrent metabolic derangement, sleep deprivation and withdrawal from alcohol were associated with epileptic seizures. EEG abnormalities were associated with the diagnosis of epileptic seizures while MRI abnormalities were not. Discrimination between epileptic seizures and syncope by CSSS was concordant wit...

The Influence of L-Carnitine in the Complex Treatment of Patients with Renal Dysfunction Who Have Synchronous Chronic Coronary Artery Disease and Prostate Adenocarcinoma

“…10 It should be noted that there is an evidence base for the clinical use of L-Carnitine in chronic kidney disease patients receiving dialysis therapy, in patients with cardiovascular, neurological diseases, etc. [11][12][13] Particularly the recent meta-analysis has demonstrated that L-Carnitine treatment is effective for improving clinical symptoms and cardiac functions, decreasing serum levels of B-type natriuretic peptide (BNP) and N-terminal-pro-BNP in chronic heart failure (CHF) patients. 14 Thus, the recommendations of the American Association of Cardiologists for the management of patients with CHF note that the pharmacological treatment of CHF can be supplemented with L-Carnitine.…”