RESUMO
INTRODUCTION: Vigabatrin (VGB), a second-generation antiepileptic drug, is effective for the treatment of infantile spasms and focal seizures, primarily in tuberous sclerosis complex (TSC) patients. However, reports of adverse events of VGB, including VGB-associated visual field loss and brain abnormalities in neuroimaging, have raised concerns about the broader use of VGB and thus significantly limited its application. AIM OF THE STUDY: The goal of this review was to summarise the recent therapeutic guidelines, the use of VGB in focal seizures and new VGB applications as a disease-modifying treatment in TSC patients. Moreover, we discuss the current opinions on potential VGB-associated toxicity and the safety of VGB.
Assuntos
Epilepsia , Espasmos Infantis , Esclerose Tuberosa , Anticonvulsivantes/efeitos adversos , Criança , Epilepsia/tratamento farmacológico , Humanos , Espasmos Infantis/tratamento farmacológico , Esclerose Tuberosa/tratamento farmacológico , Vigabatrina/efeitos adversosRESUMO
Gadolinium-based contrast agents (GBCAs) are widely used in magnetic resonance imaging (MRI) to help with the diagnostic and monitoring processes of many diseases, including neurological disorders. Initially, it was assumed that GBCAs carry minimal risk, are safe and well tolerated. But recent reports of GBCA-associated deposition in many body tissues have raised concerns about the broader health impacts of gadolinium exposure. The aim of this review was to summarise knowledge regarding gadolinium deposition, primarily in the brain structures, and of potential GBCA-associated toxicity. Moreover, we discuss the current recommendations on the use of GBCAs, as well as alternative contrast agents and imaging techniques.
Assuntos
Doenças do Sistema Nervoso , Encéfalo , Meios de Contraste/efeitos adversos , Gadolínio , Humanos , Imageamento por Ressonância Magnética , Doenças do Sistema Nervoso/induzido quimicamenteRESUMO
INTRODUCTION: Epilepsy is a chronic neurological disease, usually decreasing the quality of life and often resulting in other comorbidities e.g. cognitive impairment in children. Despite the recent discovery of new antiepileptic drugs, roughly one in three patients suffers from drug-resistant seizures. Therefore, the prevention of epilepsy is becoming one of the most important challenges in medicine. Is it, however, in fact possible to prevent epilepsy? CLINICAL REFLECTIONS AND IMPLICATIONS: We present the results of preventive antiepileptic treatment in children with Sturge-Weber syndrome and Tuberous Sclerosis Complex as examples of the possible prevention of epilepsy and epilepsy-associated cognitive impairment in children.
