Pediatric neurology
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Pediatric neurology · Jul 2009
Comparative Study Clinical TrialNarcolepsy: action of two gamma-aminobutyric acid type B agonists, baclofen and sodium oxybate.
This study was performed to evaluate the actions of baclofen and sodium oxybate, two medications with gamma-aminobutyric acid type B (GABA(B)) receptor agonist properties, on symptoms of narcolepsy in drug-naïve teenagers. Twenty-six narcoleptic teenagers with recent onset of narcolepsy-cataplexy syndrome who were human leukocyte antigen DQB1 0602 positive were matched for age and sex and received either baclofen or sodium oxybate. If deemed necessary to combat excessive daytime sleepiness, the alerting agent modafinil was also prescribed. ⋯ Both drugs increased total sleep time and delta waves during sleep, but only sodium oxybate had an effect on daytime sleepiness and cataplexy at 3 months. Improvement of total nocturnal sleep time had no beneficial effect on daytime sleepiness. The mechanism by which sodium oxybate improves cataplexy and sleepiness is inferred to be due to properties beyond direct GABA(B) agonist action.
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Pediatric neurology · Jul 2009
Role of intravenous levetiracetam in acute seizure management of children.
Status epilepticus is defined as a seizure lasting beyond 30 minutes. Children with intractable epilepsy undergo frequent hospital admissions secondary to status epilepticus or because of acute exacerbation of seizures. Intravenous levetiracetam became available in August 2006 for use in patients aged above 16 years. ⋯ No serious side effects were evident. Fifteen patients (46.8%) were discharged on levetiracetam monotherapy, and 9 (28.1%) received levetiracetam as adjunctive therapy after discharge from the hospital. Intravenous levetiracetam can be used adjunctively or as monotherapy in children with status epilepticus and acute exacerbation of seizures.