Analysis of reasons for low adherence to antiepileptic therapy in patients with symptomatic epilepsy

Background There is no consensus as to whether balloon angioplasty alone or stent placement is effective for sinus occlusion associated with dural arteriovenous fistula (DAVF). Herein, we first report a case of transverse sinus occlusion associated with DAVF in which gradual sinus dilatation was observed after balloon angioplasty with embolization of the affected sinus with shunt flow. Case presentation A 69-year-old man presented with executive dysfunction. Magnetic resonance imaging revealed left transverse sinus–sigmoid sinus DAVF with occlusion of the left jugular vein and right transverse sinus. Before endovascular treatment, the patient had symptomatic epilepsy and subarachnoid hemorrhage. Retrograde leptomeningeal venous drainage disappeared with packing of the left transverse sinus–sigmoid sinus. Subsequently, balloon angioplasty of the right occluded transverse sinus was performed to maintain the normal venous drainage and remaining shunt outflow. Dilatation of the right transverse sinus was poor immediately after surgery. However, angiography after 10 days and 6 months revealed gradual dilatation of the right transverse sinus. Conclusion Sinus occlusion, which is thought to be caused by sinus hypertension associated with DAVF rather than chronic organized thrombosis or thrombophilia, may dilate over time after balloon angioplasty and shunt flow reduction if occluded sinus is necessary for facilitating normal venous drainage.

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Predictors of seizure onset after intracerebral hemorrhage and the role of long-term antiepileptic therapy

Journal of Critical Care ◽

10.1016/j.jcrc.2008.10.015 ◽

2009 ◽

Vol 24 (3) ◽

pp. 335-339 ◽

Cited By ~ 29

Author(s):

Matthew C. Garrett ◽

Ricardo J. Komotar ◽

Robert M. Starke ◽

Maxwell B. Merkow ◽

Marc L. Otten ◽

...

Keyword(s):

Intracerebral Hemorrhage ◽

Seizure Onset ◽

Antiepileptic Therapy

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Plasma vitamin values and antiepileptic therapy: Case reports of pregnancy outcomes affected by a neural tube defect

Birth Defects Research Part A Clinical and Molecular Teratology ◽

10.1002/bdra.20318 ◽

2007 ◽

Vol 79 (1) ◽

pp. 62-64 ◽

Cited By ~ 17

Author(s):

Mirande Candito ◽

Mourad Naimi ◽

Catherine Boisson ◽

Jean-Charles Rudigoz ◽

Pascal Gaucherand ◽

...

Keyword(s):

Neural Tube ◽

Neural Tube Defect ◽

Pregnancy Outcomes ◽

Case Reports ◽

Plasma Vitamin ◽

Antiepileptic Therapy

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Bone mineral density in children with long-term antiepileptic therapy

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1306329d ◽

2013 ◽

Vol 141 (5-6) ◽

pp. 329-332 ◽

Cited By ~ 2

Author(s):

Milena Dimic ◽

Aleksandar Dimic ◽

Zoran Milosevic ◽

Jelena Vojinovic

Keyword(s):

Bone Mineral Density ◽

Vitamin D ◽

Drug Therapy ◽

Antiepileptic Drug ◽

Bone Mineral ◽

Control Group ◽

Mineral Density ◽

Antiepileptic Therapy ◽

Epileptic Children ◽

Antiepileptic Drug Therapy

Introduction. Vitamin D active metabolites deficit that is altered by negative calcium and phosphorus balance is a potential complication during long?term antiepileptic drug therapy. Objective. The aim of this study was to examine lumbar bone mineral density (BMD) in epileptic children receiving antiepileptic drug therapy longer than one year. methods. The examined sample consisted of 34 epileptic children, 18 male and 16 female, aged 6?12 (9.77?2.01) years, treated with carbamazepine, valproate, phenobarbital, lamotrigine or their combination without vitamin D supplementation. The lumbar spine BMD (L1?L4) was estimated by a Lunar densitometer and obtained results were compared with results of 35 matched population of healthy children from the control group. results. Lumbar BMD Z?score was significantly lower in female patients treated with antiepileptic therapy compared with those in the control group (?1.048?1.35 vs. ?0.399?0.518; p=0.03). Bone mineral density Z?score decrease of both gender groups receiving antiepileptic polytherapy was significantly lower compared to the control group (?1.153?0.938 vs. ?0.043?0.815; p=0.007). Therapy duration had no influence on the lumbar BMD level decrease either in boys (rxy=0.33; p=0.174) or in girls (rxy=0.02; p=0.935) treated with antiepileptic therapy. Conclusion. Our results have indicated that antiepileptic drug therapy usage longer than one year can have adverse affects on the lumbar spine BMD (L1?L4) in epileptic children, and that prophylactic vitamin D supplementation is also necessary in these patients.

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