Introduction: Continuous apomorphine infusion (CAI) is effective in improving complications in advanced Parkinson’s disease (APD). The effectiveness and tolerance of CAI in patients with APD with varying degrees of f...Introduction: Continuous apomorphine infusion (CAI) is effective in improving complications in advanced Parkinson’s disease (APD). The effectiveness and tolerance of CAI in patients with APD with varying degrees of functional impairment was studied. Methods: In this comparative observational study, consecutive APD who started treatment with CAI were included. They were classified into two groups of functional impairment: A) moderate (Schwab and England (S & E) = 60% - 80% and Hoehn and Yahr (H & Y) = 2 - 3;Group (A), and (B) severe (S & E 3;Group B). Clinical follow-up was performed with concomitant medication and CAI adjustment at 3, 6 and 12 months. Clinical evaluation included a dyskinesia diary and AIMS, S & E, NPI, NMSS and HADS questionnaires. Results: Eighteen patients participated (A = 9 and B = 9) with EP diagnosed 7 (A) and 13 (B) years before. Their baseline dose of levodopa was 728 mg (A) and 925 mg (B), which did not change during follow-up. Dopamine agonists were progressively reduced in both groups. Progressive titration of CAI resulted in abandonment of apomorphine bolus administration. Both groups experienced improvements in all variables, higher in group A;motor fluctuations = 69% (A), 53% (B);AIMS = 82% (A), 71 (B);S & E = 32% (A), 18% (B);NMS = 62% (A), 19% (B);NPI = 75% (A), 50% (B);HADS (anxiety) = 26% (A), 21% (B);HADS (depression) = 52% (A), 31% (B). Adverse effects were generally mild and resolved without reducing CAI dose. There were no withdrawals. Conclusions: Patients with APD and moderate functional impairment treated with CAI may obtain greater functional, cognitive and emotional improvement than patients more severely affected.展开更多
The efficacy and the tolerance of the AEDs have been extensibly studied in the past, however the effects of them on the EEG activity of epileptic patients have been scarcely studied. Eslicarbazepine is a third generat...The efficacy and the tolerance of the AEDs have been extensibly studied in the past, however the effects of them on the EEG activity of epileptic patients have been scarcely studied. Eslicarbazepine is a third generation blocker-sodium channels AED associated with a high reduction in the rate of partial seizures in epileptic patients. We designed an open label, non control study to determine the effects of Eslicarbazepine on the EEG activity of EP with focal seizures in a 12-week follow up. The EP with focal paroxystical activity enrolled in this study showed a statistical significant reduction in the rate of monthly seizures when Eslicarbazepine 800 mgs was added to a previous AED compared to those patients who only received an increase of the AED in monotherapy, concomitantly, EP treated with ESL added to a previous AED showed a statistically significant reduction in the mean occipital frequency and voltage amplitude in the central and parietal regions in the twelfth-week EEG compared to the control group.展开更多
文摘Introduction: Continuous apomorphine infusion (CAI) is effective in improving complications in advanced Parkinson’s disease (APD). The effectiveness and tolerance of CAI in patients with APD with varying degrees of functional impairment was studied. Methods: In this comparative observational study, consecutive APD who started treatment with CAI were included. They were classified into two groups of functional impairment: A) moderate (Schwab and England (S & E) = 60% - 80% and Hoehn and Yahr (H & Y) = 2 - 3;Group (A), and (B) severe (S & E 3;Group B). Clinical follow-up was performed with concomitant medication and CAI adjustment at 3, 6 and 12 months. Clinical evaluation included a dyskinesia diary and AIMS, S & E, NPI, NMSS and HADS questionnaires. Results: Eighteen patients participated (A = 9 and B = 9) with EP diagnosed 7 (A) and 13 (B) years before. Their baseline dose of levodopa was 728 mg (A) and 925 mg (B), which did not change during follow-up. Dopamine agonists were progressively reduced in both groups. Progressive titration of CAI resulted in abandonment of apomorphine bolus administration. Both groups experienced improvements in all variables, higher in group A;motor fluctuations = 69% (A), 53% (B);AIMS = 82% (A), 71 (B);S & E = 32% (A), 18% (B);NMS = 62% (A), 19% (B);NPI = 75% (A), 50% (B);HADS (anxiety) = 26% (A), 21% (B);HADS (depression) = 52% (A), 31% (B). Adverse effects were generally mild and resolved without reducing CAI dose. There were no withdrawals. Conclusions: Patients with APD and moderate functional impairment treated with CAI may obtain greater functional, cognitive and emotional improvement than patients more severely affected.
文摘The efficacy and the tolerance of the AEDs have been extensibly studied in the past, however the effects of them on the EEG activity of epileptic patients have been scarcely studied. Eslicarbazepine is a third generation blocker-sodium channels AED associated with a high reduction in the rate of partial seizures in epileptic patients. We designed an open label, non control study to determine the effects of Eslicarbazepine on the EEG activity of EP with focal seizures in a 12-week follow up. The EP with focal paroxystical activity enrolled in this study showed a statistical significant reduction in the rate of monthly seizures when Eslicarbazepine 800 mgs was added to a previous AED compared to those patients who only received an increase of the AED in monotherapy, concomitantly, EP treated with ESL added to a previous AED showed a statistically significant reduction in the mean occipital frequency and voltage amplitude in the central and parietal regions in the twelfth-week EEG compared to the control group.
