Visual field defects in patients taking vigabatrin.

PURPOSE: To investigate visual field loss in patients on long-term treatment with the antiepileptic drug vigabatrin, recently reported to cause visual disturbances. METHODS: Eighteen patients taking vigabatrin for 0.5-9.5 years were examined with automated perimetry up to 60 degrees from fixation using the Humphrey Field Analyser. Five patients with epilepsy receiving other medications served as controls. Patients found to have a visual field defect underwent ophthalmologic examination. RESULTS: Among the 18 patients in the vigabatrin group, visual field defects categorised as mild were revealed in 6 right eyes (33%) and 8 left eyes (44.4%), while defects categorised as severe were found in 9 right eyes (50%) and 8 left eyes (44.4%). The majority of the defects (66.7% in the right eye) were peripheral constriction with nasal predominance. The location of the defects was confirmed in 8 patients also tested with Kowa AP340 perimetry. CONCLUSION: According to our results, visual field defects among the patients on vigabatrin therapy may occur more frequently than previously recognised.

[Sumatriptan in the treatment of migraine in general practice]. / Sumatriptan i behandling av migrene i allmennpraksis.

Approximately 5% of the adult Norwegian population suffer from migraine. Sumatriptan is a new anti-migraine drug which has been shown in clinical studies to be efficacious in up to 80% of attacks treated. These early clinical studies have all been carried out at specialist centres and the present study was planned to see if migraine patients treated by general practitioners would also benefit from this new therapy. This placebo controlled, randomized, double blind study was carried out by 50 general practitioners and two neurologists, and included 294 patients. A total of 1,485 migraine attacks were treated. The results show that Sumatriptan is equally efficacious and well tolerated when used to treat patients in general practice as at specialist clinics. Sumatriptan was efficacious in relieving pain and other migraine symptoms in 76% of the migraine attacks treated, while placebo had the desired effect in 29% of attacks.