Random total antiepileptic drug levels and seizure control during pregnancy.

OBJECTIVE: To study the correlation of randomly-tested total antiepileptic plasma levels and seizure control in a retrospectively collected group of pregnant epileptic Saudi women. METHODS: The medical records of 30 Saudi epileptic female patients were reviewed during their subsequent pregnancies (total of 50). The type of antiepileptic drugs used during each pregnancy, the dose of each drug and the corresponding total plasma levels were noted. Antiepileptic drugs assay were carried out randomly during pregnancy either by TDX or a sensitive high performance liquid chromatography method. RESULTS: A total of 50 pregnancies were studied. The most common seizure type in these women was complex partial seizure followed by primary generalized epilepsy, myoclonic seizures and of least occurrence was the simple partial seizure with secondary generalization. All patients were received antiepileptic drugs, including either carbamazepine, phenytoin, valporic acid, phenobarbitone or clonazepam. In a total of 24 pregnancies (48%), the serum levels of antiepileptic drugs were subtherapeutic during the first trimester. Recurrent seizures occurred in a total of 20 pregnancies (40%) especially in the 3rd trimester. CONCLUSION: It is concluded that subtherapeutic serum levels of antiepileptic drugs correlated highly with the increased frequency of seizure in these pregnant women. Monitoring of state of seizure control in epileptic pregnant women should be made regularly during the course of their pregnancies.

Random total antiepilectic drug levels and seizure control during pregnancy.

OBJECTIVE: To study the correlation of randomly-tested total antiepileptic plasma levels and seizure control in a retrospectively collected group of pregnant epileptic Saudi women. METHODS: The medical records of 30 Saudi epileptic female patients were reviewed during their subsequent pregnancies (total of 50). The type of antiepileptic drugs used during each pregnancy, the dose of each drug and the corresponding total plasma levels were noted. Antiepileptic drugs assay were carried out randomly during pregnancy either by TDX or a sensitive high performance liquid chromatography method. RESULTS: A total of 50 pregnancies were studied. The most common seizure type in these women was complex partial seizure followed by primary generalized epilepsy, myoclonic seizures and of least occurrence was the simple partial seizure with secondary generalization. All patients were received antiepileptic drugs, including either carbamazepine, phenytoin, valporic acid, phenobarbitone or clonazepam. In a total of 24 pregnancies (48%), the serum levels of antiepileptic drugs were subtherapeutic during the first trimester. Recurrent seizures occurred in a total of 20 pregnancies (40%) especially in the 3rd trimester. CONCLUSION: It is concluded that subtherapeutic serum levels of antiepileptic drugs correlated highly with the increased frequency of seizure in these pregnant women. Monitoring of state of seizure control in epileptic pregnant women should be made regularly during the course of their pregnancies.

Parkinson's disease. Clinical and electrophysiological evaluation.

OBJECTIVES: Identification of the clinical spectrum and the electrophysiological responses of a Saudi population with Parkinson's disease as opposed to a matched normal population. METHODS: Fifty four subjects (41 males and 13 females) were selected for the study. The patients were clinically evaluated for the occurrence of Parkinson's disease symptoms, as well as other associated medical conditions. All patients had brain computerized tomography scans. Electrophysiological tests were performed on all patients using the Medelec ST 10 Sensor 59394 Model. These tests included somatosensory evoked response of median nerves, brain stem auditory evoked responses and visual evoked responses. The significant differences in these evoked responses between the patients with Parkinson's disease and normal patients were statistically evaluated. RESULTS: Twenty six out of the 40 computerized tomography brain scans which had been carried out showed normal brain morphology and 5 had a clear evidence of cerebrovascular disease while only 9 showed distinctive brain atrophy. The mean values for the brain stem auditory evoked response, the somatosensory evoked response and the visual evoked responses were higher in patients with Parkinson's disease as compared to those who did not have the disease. Significant differences were only seen as prolonged latencies in median nerve somatosensory evoked response, as well as delayed waves I and V on the brain stem auditory evoked response. Inter-wave latencies, however, were not significantly different. CONCLUSION: Parkinson's disease in a Saudi population showed significant differences to somatosensory evoked response and brain stem auditory evoked response electrophysiological data as compared to age-matched controls, however, the clinical characteristics of Parkinson's disease in Saudi patients are not significantly different from those reported for patients elsewhere.

Tumor-like presentation of multiple sclerosis.

Multiple sclerosis patients may present with clinical data suggestive of cerebral tumor, however, most of the lesions do not show expansive signs in computerized tomography of brain or magnetic resonance imaging. We report in this paper, 2 patients who had shown expansive radiological signs suggestive of neoplasm. Cerebral biopsy was an important diagnostic procedure in these 2 cases which revealed the diagnosis of demyelinating disease.

Parkinson`s disease. Clinical and electrophysiology evaluation.

OBJECTIVE: Identification of the clinical spectrum and the electrophysiological responses of a Saudi population with Parkinson`s disease as opposed to a matched normal population. METHODS: Fifty four subjects (41 males and 13 females) were selected for the study. The patients were clinically evaluated for the occurrence of Parkinson`s disease symptoms, as well as other associated medical conditions. All patients had brain computerized tomography scans. Electrophysiological tests were performed on all patients using the Medelec ST 10 Sensor 59394 Model. These tests included somatosensory evoked response of median nerves, brain stem auditory evoked responses and visual evoked responses. The significant differences in these evoked responses between the patients with Parkinson`s disease and normal patients were statistically evaluated. RESULTS: Twenty six out of the 40 computerized tomography brain scans which had been carried out showed normal brain morphology and 5 had a clear evidence of cerebrovascular disease while only 9 showed distinctive brain atrophy. The mean values for the brain stem auditory evoked response, the somatosensory evoked response and the visual evoked responses were higher in patients with Parkinson`s disease as compared to those who did not have the disease. Significant differences were only seen as prolonged latencies in median nerve somatosensory evoked response, as well as delayed waves I and V on the brain stem auditory evoked response. Inter-wave latencies, however, were not significantly different. CONCLUSION: Parkinson`s disease in a Saudi population showed significant differences to somatosensory evoked response and brain stem auditory evoked response electrophysiological data as compared to age-matched controls, however, the clinical characteristics of Parkinson`s disease in Saudi patients are not significantly different from those reported for patients elsewhere.

Terminal Latency Index: A distinctive diagnostic criterion for carpal tunnel syndrome.

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