Swiss medical weekly
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Swiss medical weekly · Jan 1995
Review[Vigabatrin and lamotrigin: experiences with 2 new anticonvulsants in the Swiss epilepsy clinic].
Vigabatrin and lamotrigine are two new antiepileptic drugs which have recently become available. Vigabatrin is a specific and irreversible inhibitor of the enzyme gamma-amino-butyric-acid (GABA) transferase. Its administration leads to a long lasting increase in GABA, the most important inhibitory neurotransmitter. ⋯ Lamotrigine is also effective in the treatment of partial seizures, for which it is approved. However, uncontrolled studies and our own experience have shown that it is even more effective in generalized seizures. As add-on therapy in absences and tonic or tonic-clonic seizures, a significant reduction in seizure frequency--in individual cases seizure freedom--can be achieved.(ABSTRACT TRUNCATED AT 250 WORDS)
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Spinal cord damage is one of the main dose limiting processes in radiation therapy. Radiation myelopathy was first observed in 1941, but it was only in the early 1980s that more clear information on tolerance was available. Animal experimentation in particular has thrown light on pathogenesis and factors playing a role in this pathology. ⋯ Vascular damage may or may not be present. A dual pathogenesis is postulated. Oligodendrocytes and endothelial cells are the most likely target cells.(ABSTRACT TRUNCATED AT 250 WORDS)
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Basilar artery thrombosis is a potentially treatable neurologic disease whose initial symptoms are sometimes difficult to recognize. The basilar artery is hyperdense on computed tomography in cases with basilar artery thrombosis. ⋯ While it is not always possible to detect basilar artery thrombosis simply by evaluation of the tomodensitometric values before or after contrast, the differential values obtained by subtracting them (after contrast/before), or by an attenuation ratio corresponding to the differential value divided by the value before contrast, are more helpful. Indeed, the differential values and attenuation ratios in the normal population have a mean value of 51.1 and 1.37 compared with 14.47 and 0.33 in patients with basilar artery thrombosis.