title: The effect of different vigabatrin treatment regimens on CSF biochemistry and seizure control in epileptic patients.
abstract: 1. Vigabatrin, 50 mg kg-1, was administered orally as add-on therapy to 11 patients with drug-resistant complex partial epilepsy as a single dose, then once every third day for 2 months, every other day for 2 months and daily for 1 month. 2. Lumbar punctures were carried out prior to treatment and at the end of each dosage regimen and cerebrospinal fluid (CSF) evaluated for concentrations of free and total GABA, homocarnosine (GABA-histidine dipeptide), homovanillic acid (HVA), 5-hydroxyindole acetic acid (5-HIAA) and vigabatrin. 3. Each regimen resulted in significant increases in CSF concentrations of free and total GABA and homocarnosine compared with the immediately preceding regimen. 4. CSF concentrations of HVA significantly increased after a single vigabatrin dose but returned to pre-treatment levels with subsequent dosing schedules. In contrast, 5-HIAA concentrations also increased with the single dose but were significantly decreased, compared with pre-treatment values, following alternate day and daily vigabatrin administration. 5. Seizure frequency progressively decreased with decreasing dosing interval. Daily vigabatrin administration was associated with greater than 50% decrease in seizures in 8 of the 10 patients treated.
authors: Department of Neurology, University of Göteborg, Sweden.
authors: E
authors: E
authors: Ben-Menachem
authors: L I
authors: LI
authors: Persson
authors: P J
authors: PJ
authors: Schechter
authors: K D
authors: KD
authors: Haegele
authors: N
authors: N
authors: Huebert
authors: J
authors: J
authors: Hardenberg
authors: L
authors: L
authors: Dahlgren
authors: J P
authors: JP
authors: Mumford
mesh_terms: D000328:Adult; D000614:Aminocaproates / Q000009:adverse effects / Q000627:therapeutic use*; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use*; D002336:Carnosine / Q000031:analogs & derivatives / Q000097:blood; D002556:Cerebrospinal Fluid Proteins / Q000378:metabolism*; D004827:Epilepsy / Q000134:cerebrospinal fluid / Q000188:drug therapy*; D005260:Female; D006719:Homovanillic Acid / Q000134:cerebrospinal fluid; D006801:Humans; D006897:Hydroxyindoleacetic Acid / Q000134:cerebrospinal fluid; D008297:Male; D008875:Middle Aged; D020888:Vigabatrin; D005680:gamma-Aminobutyric Acid / Q000134:cerebrospinal fluid
chemical_list: D000614:Aminocaproates; D000927:Anticonvulsants; D002556:Cerebrospinal Fluid Proteins; C005038:homocarnosine; D006897:Hydroxyindoleacetic Acid; D005680:gamma-Aminobutyric Acid; D002336:Carnosine; D020888:Vigabatrin; D006719:Homovanillic Acid