ABSTRACT
1. The regional cerebral blood flow was studied by SPECT in patients with partial epilepsy before and after 30 days of monotherapy with carbamazepine (CBZ). 2. Both a qualitative visual interpretation and a semiquantitative analysis of SPECT was performed. All patients underwent EEG, CT scan, and MRI studies. The CBZ serum concentrations were assayed. 3. After therapy, in three patients with focal epilepsy, both a crossed cerebral and cerebellar diaschisis were observed, with respect to the side of the epileptic focus in the opposite hemisphere. No morphologic changes were detected at MRI in the cerebral or cerebellar remote hypometabolic areas found at SPECT. 4. CBZ may have a depressant action on the corticopontocerebellar pathways and on the corticocallosal connections.
Subject(s)
Blood Flow Velocity , Brain Damage, Chronic/chemically induced , Carbamazepine/adverse effects , Carbamazepine/therapeutic use , Cerebrovascular Circulation/drug effects , Epilepsy, Complex Partial/drug therapy , Adolescent , Adult , Female , Humans , Male , Tomography, Emission-Computed, Single-PhotonABSTRACT
After oral administration (10% suspension in arabic gum, at 500 mg/kg), total phenytoin (PHT) concentrations were measured in the blood and brain of rats anesthetized with ketamine (60 mg/kg, intraperitoneally i.p.) and in a control group that received only PHT. The concentration of PHT in blood and brain was significantly higher in the ketamine than in the control group. At 1, 1.5, 2, and 3 h, increased brain PHT reflected increased blood concentrations. At all times, the plasma protein binding of PHT was similar in both groups. After intravenous (i.v.) administration, instead, at 10 mg/kg, total PHT concentrations were similar in rats anesthetized with ketamine (60 mg/kg, i.p.) and in a control group that received only PHT under mild ether anesthesia. Thus, the main factor involved with the altered PHT biodisposition caused by ketamine anesthesia appears to be increased absorption of the drug.
Subject(s)
Anesthesia/methods , Electroencephalography/drug effects , Ketamine/pharmacology , Phenytoin/pharmacokinetics , Administration, Oral , Anesthesia/veterinary , Animals , Blood Proteins/metabolism , Brain Chemistry/drug effects , Drug Interactions , Injections, Intraperitoneal , Injections, Intravenous , Ketamine/administration & dosage , Ketamine/pharmacokinetics , Male , Phenytoin/administration & dosage , Phenytoin/pharmacology , Protein Binding/drug effects , Rats , Rats, Inbred StrainsABSTRACT
Three patients with postural and intention cerebellar tremor caused by a cerebellar infarction in the superior cerebellar artery distribution were studied; treatment with carbamazepine resulted in marked improvement.
