[Cerebral concentrations of anticonvulsants in patients with epilepsy of tumoral origin (author's transl)].
(1) The concentrations of various anticonvulsants (PB, PHT, CBZ, VPA) were measured in brain specimens from 7 patients who had undergone neurosurgery for a therapy resistant epilepsy of tumoral origin (astrocytoma) in 6 cases, glioblastoma in 1 case). (2) Great interindividual variability of the mean brain/plasma concentration ratios was observed for PB in 5 patients (range: 0.4-1.0). A mean brain/plasma ratio of 1.0 was recorded for PHT and CBZ (one patient each). (3) In the different tissue specimens (7-14) from the same patient AED concentrations varied greatly, even in neighboring areas. (4) Intraindividual variations were more marked in the present group of patients than in previously studied non-tumoral epileptics. (5) No correlation was found between the localization of the lesions and the variations in AED concentrations. (6) Brain AED concentration appeared to be higher in the few samples of non-tumoral tissue and lower in the 'epileptogenic' areas as defined by stereo-EEG seconding. (7) On the basis of these data, the hypothesis can be formulated that the therapy resistance of these patients may be at least partly explained by the presence of low AED concentration (even in presence of 'therapeutic' AED plasma levels) in the epileptogenic areas.
D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000032:analysis* / Q000097:blood; D001254:Astrocytoma / Q000150:complications*; D001923:Brain Chemistry; D001932:Brain Neoplasms / Q000150:complications*; D002541:Cerebral Decortication; D002648:Child; D004827:Epilepsy / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D005260:Female; D005625:Frontal Lobe; D006801:Humans; D008297:Male; D009778:Occipital Lobe; D010296:Parietal Lobe
D000927:Anticonvulsants
Concentrations cérébrales des médicaments anti-comitiaux chez les malades ayant une epilepsie tumorale.