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21.09.2005:
   21.09.2005

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USE OF AMINO ACID COMPOUNDS IN COMPREHENSIVE EPILEPSY TREATMENT.

Yu.K. Khokhlov, Cand. Sc. (Med.), Asst. Prof., neuropathologist;
G.N. Fomicheva, neuropathologist, functional diagnostician
1997

INTRODUCTION

It is established now that the basis of epileptic seizures is formed by a triggering mechanism the carrier of which is a group of neurons with pathophysiologic properties that constitute an epileptic focus. The "outburst" of epileptic activity from the focus with ensuing development of clinical manifestations of disease gives evidence of insufficiency of defense mechanisms. The epileptic focus acquires features of a determinant structure. Significant energetic and transmitter disturbances are observed around the focus which leads to increased permeability of membranes and concentration of electrolytes.

Disturbances in the exchange of amino acids, particularly, of glutaminic acid (exciting transmitter) and g -Aminobutyric acid (GABA) (inhibitory transmitter) are one of the major links of these disorders. Their content as well as that of aspartic acid, glycine, taurine and others varies in the range of 30-40% of the normal level. The concentration of amino acids that do not directly participate in modulation of neuronal activity remains constant.

The objective of our study was to determine the efficacy of amino acid compound treatment of epilepsy patients with diverse forms of attacks.

MATERIAL AND STUDY METHODS

We have analyzed the treatment of 55 epileptics. There were 26 males and 29 females. Their age ranged between 2 and 50 years, predominantly, from 11 to 30 years. The duration of illness was from several months to 10 years and over. 28 patients suffered from generalized convulsive attacks, 6 from absences and 21 from mixed seizures.

In some patients convulsive seizures were recorded within the context of organic cerebral pathology, mental subnormality, oligophrenia, etc.

In 7 patients partial fits were observed as well. Their frequency was different.

All patients received preparations that raised the GABA level by simultaneously decreasing the amount of glutaminic acid (Aminovil, Trevit, Avit, Primavit) at individual dosages depending on age and seizure frequency.

Basically, control was performed by both a dynamic supervision of patients and electroencephalographically. In 55 patients EEG recordings were made with functional loads; in 24 of them an EEG was made twice: at the beginning and at the end of treatment. In 32 patients the EEG revealed an epileptic focus of different localization and in 18 diffuse alterations were registered.

Additionally, a computer brain examination was carried out in 10 patients, nuclear-magnetic tomography was performed in 7, Echo-EG in 35 and examination of the fundus of the eye in 28 subjects.

The course of treatment stretched over 4-6 weeks. 45 patients completed 1 course, 9 patients 2 courses and 1 patient 3 courses of treatment. Concurrently, all patients received basic traditional anticonvulsive therapy.

STUDY RESULTS

The treatment, taking into account catamnesis, produced the following effect: 25 patients reported a lesser frequency of attacks and in 5 patients they ceased completely.During treatment of 24 patients no attacks at all were noted while only in 1 patient their occurrence became more frequent.

EEG data were most conclusive: in 16 patients (out of 24) the EEG recorded a positive dynamics expressed in diminished epileptic activity, normalization of cortical rhythms, etc. Complete disappearance of epileptic foci was reported in 4 patients. At the same time, in 7 patients no EEG change was recorded and only in 1 negative dynamics was found which coincided with more frequent fits.

Of great interest was a change in the general condition of patients. 20 patients reported, within the context of the treatment, that the anxiety level subsided; nocturnal seizures ceased in 5 subjects. 14 patients got more quiet; children became more assiduous, actively played with toys and showed greater interest in the environment; 2 children ran more rarely away from home. 4 normalized sleep. A 14-year child learned by the end of treatment how to light matches, got interested in cars and began to read books about cars. In 1 patient the skin got clean and attacks stopped against the background of an improvement of the general condition. And only in 15 patients who underwent treatment no visible changes in behavior were recorded.

CONCLUSION

Thus, the use of amino acid compounds in comprehensive epilepsy treatment produces an essential favorable effect and can be recommended with concurrent correction of anticonvulsant preparations.


 
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