Henoch-Schonlein purpura due to sodium valproate: A Case report

The etiology of Henoch-Schönlein purpura (HSP) has been frequently attributed to certain drugs. Anticonvulsive drugs are reported rarely in drug-induced HSP.We report a 5-year-old girl with a seizure treated with sodium valproate. we report a case of HSP due to the consumption of sodium valproate..

MANAGEMENT OF STATUS EPILEPTICUS IN COMATOSE PATIENTS

Among the patients with different types of Epilepsy, there is one of the most dangerous form named - Status Epilepticus, which needs emergency management. Without early response and correct treatment, patient’s health condition may become critical up to death. The most difficult treatment of Status Epilepticus is in patients with unknown coma. Under our observation, there were 22 patients with different etiological factors of coma. For clinical observation we used EEG monitoring and MRI scan in dynamics. According the health history of patients, we find out that 9 of them had immunological and unknown disorders causing Status Epilepticus. In three cases, main disease progression was determined without any leader etiological factors, which might cause immunological disorders. In 7 cases, there were nonconvulsive Status epilepticus. While all of these patients were under the general anesthesia, we were using anticonvulsive drugs in combination with immunotherapy and hormonotherapy. In two cases, we could not control Status Epilepticus. The EEG and MRI scan monitoring in dynamics shows us that difficulty in control of SE might be caused by exacerbation of the main disease. In conclusion, the acute disorders of central neuron system and early response of critical conditions are very important in correct and high quality management of both: Convulsive and non-Convulsive types of Status Epilepticus.

Epilepsy in Nicolaides–Baraitser Syndrome: Review of Literature and Report of 25 Patients Focusing on Treatment Aspects

Nicolaides–Baraitser syndrome (NCBRS), caused by a mutation in the SMARCA2 gene, which goes along with intellectual disability, congenital malformations, especially of face and limbs, and often difficult-to-treat epilepsy, is surveyed focusing on epilepsy and its treatment. Patients were recruited via “Network Therapy of Rare Epilepsies (NETRE)” and an international NCBRS parent support group. Inclusion criterion is NCBRS-defining SMARCA2 mutation. Clinical findings including epilepsy classification, anticonvulsive treatment, electroencephalogram (EEG) findings, and neurodevelopmental outcome were collected with an electronic questionnaire. Inclusion of 25 NCBRS patients with epilepsy in 23 of 25. Overall, 85% of the participants (17/20) reported generalized seizures, the semiology varied widely. EEG showed generalized epileptogenic abnormalities in 53% (9/17), cranial magnetic resonance imaging (cMRI) was mainly inconspicuous. The five most frequently used anticonvulsive drugs were valproic acid (VPA [12/20]), levetiracetam (LEV [12/20]), phenobarbital (PB [8/20]), topiramate (TPM [5/20]), and carbamazepine (CBZ [5/20]). LEV (9/12), PB (6/8), TPM (4/5), and VPA (9/12) reduced the seizures' frequency in more than 50%. Temporary freedom of seizures (>6 months) was reached with LEV (4/12), PB (3/8), TPM (1/5, only combined with PB and nitrazepam [NZP]), and VPA (4/12). Seizures aggravation was observed under lamotrigine (LTG [2/4]), LEV (1/12), PB (1/8), and VPA (1/12). Ketogenic diet (KD) and vagal nerve stimulation (VNS) reduced seizures' frequency in one of two each. This first worldwide retrospective analysis of anticonvulsive therapy in NCBRS helps to treat epilepsy in NCBRS that mostly shows only initial response to anticonvulsive therapy, especially with LEV and VPA, but very rarely shows complete freedom of seizures in this, rather genetic than structural epilepsy.

PROBLEM OF ‘DRUG ABUSE’ IN AGING PEOPLE

The article provides the review of the current approaches to the problem of drug abuse in people of advanced age (65 and more). Method of research. Content analysis of PubMed, Medline and PsycINFO resources, using search terms: “neuroleptics”, “antidepressants”, “anticonvulsive drugs”; “abuse”, “non-medical use”, “addiction”, individual drug classes, individual substances, various combinations of substances, metaanalyses of the research of “drug abuse” in people of advanced aging people. The results of the content analysis show that any medicine, which can cause psychoactive effect of any kind, for example relaxation, sedation, intoxication, euphoria, increase of energy, can become an object of abuse. Conclusion. 1. Psychotropic drugs often have the potential for abuse by aging people with addiction. 2. Abuse of psychotropic substances significantly alters the clinical picture of an already formed drug dependence. 3. The problem requires new therapeutic approaches and complicates statistical processing and analysis of the existing problem. 4. Physicians who prescribe psychotropic drugs to aging people should be well aware of the potential risks of their use.

Evidence for Involvement of TRPV1 Receptors and Potassium Channels in the Seizures Induced by α-Sanshool

α-Sanshool is an alkamide isolated from the stem bark of Zanthoxylum liebmannianum, a Mexican medicinal plant known as Colopahtle. Our research group has reported that the intraperitoneal administration of α-sanshool induces tonic-clonic seizures in mice. In the present study, we investigated the convulsive effect of this alkamide and elucidated its mechanism of action by comparing with well-known convulsive and anticonvulsive drugs in an in vivo approach. α-Sanshool showed a potent (ED50 [CL 95%]=3.06 [2.92–3.22] mg/kg) and immediate (2±2 s) seizure effect after the intraperitoneal administration in mice. The convulsive effect of this alkamide was only observed for intraperitoneal administration; the oral route did not show any effect. α-Sanshool was less potent than strychnine (ED50 [CL 95%]=1.53 [1.44–1.62] mg/kg), but more effective than bicuculline, 4-aminopyridine, affinin, and pentylenetetrazol, in that order. The seizures induced by α-sanshool were reduced by capsazepine and diazoxide, suggesting the involvement of TRPV1 and potassium channels in the mechanism of action of this compound.