title: Gamma-vinyl GABA (vigabatrin) in epilepsy: clinical, neurochemical, and neurophysiologic monitoring in epileptic patients.
abstract: We report long-term clinical, neurochemical, and electrophysiologic data of gamma-vinyl GABA (GVG, vigabatrin) in three groups of patients. GVG was started as add-on therapy for 75 patients with refractory complex partial seizures (group A) and for 36 mentally handicapped patients with severe epilepsy (group B). The third group (C) consisted of 20 patients with carbamazepine (CBZ) monotherapy, in half of whom GVG monotherapy was substituted. After 3 months, 55% of patients in group A and 42% in group B were responders (reduction in seizure frequency greater than 50%). After 6 (group A) and 3 years (group B) of follow-up, 27 and 33% of the patients, respectively, still had good response to GVG. Neurochemical measurements showed a twofold increase in CSF GABA concentrations and minimal or no changes in other neurotransmitter-related parameters. In group C, substitution of GVG as medication tended to normalize the lengthened latencies in somatosensory evoked potentials (SEPs) observed during CBZ treatment.
authors.affiliation: Department of Neurology and Neurophysiology, University of Kuopio, Finland.
authors.forename: A
authors.initials: A
authors.lastname: Ylinen
authors.forename: J
authors.initials: J
authors.lastname: Sivenius
authors.forename: A
authors.initials: A
authors.lastname: Pitkänen
authors.forename: T
authors.initials: T
authors.lastname: Halonen
authors.forename: J
authors.initials: J
authors.lastname: Partanen
authors.forename: E
authors.initials: E
authors.lastname: Mervaala
authors.forename: J P
authors.initials: JP
authors.lastname: Mumford
authors.forename: P J
authors.initials: PJ
authors.lastname: Riekkinen
mesh_terms: D000328:Adult; D000614:Aminocaproates / Q000627:therapeutic use*; D000927:Anticonvulsants / Q000627:therapeutic use*; D002220:Carbamazepine / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004569:Electroencephalography / Q000187:drug effects*; D004827:Epilepsy / Q000134:cerebrospinal fluid / Q000188:drug therapy* / Q000503:physiopathology; D017029:Epilepsy, Complex Partial / Q000134:cerebrospinal fluid / Q000188:drug therapy / Q000503:physiopathology; D005073:Evoked Potentials, Somatosensory / Q000187:drug effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008607:Intellectual Disability / Q000150:complications; D008297:Male; D008991:Monitoring, Physiologic; D020888:Vigabatrin; D005680:gamma-Aminobutyric Acid / Q000134:cerebrospinal fluid
chemical_list: D000614:Aminocaproates; D000927:Anticonvulsants; D002220:Carbamazepine; D005680:gamma-Aminobutyric Acid; D020888:Vigabatrin