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What Clinical Observations On The Epidemiology Of Antiepileptic Drug Intractability Tell Us About The Mechanisms Of Pharmacoresistance, Michael Rogawski
What Clinical Observations On The Epidemiology Of Antiepileptic Drug Intractability Tell Us About The Mechanisms Of Pharmacoresistance, Michael Rogawski
Michael A. Rogawski
In the past several years, there have been important advances in the clinical epidemiology of antiepileptic drug resistance, as reviewed by Mohanraj and Brodie. It would appear that by and large, intractability is independent of the choice of antiepileptic drug (AED). Many patients will become seizure free on the first agent tried, irrespective of which one their physician decides to pick. Nonresponders to the first drug are in a different category: it is likely that they will continue to have seizures no matter which medicine or combination of medicines is tried. This simple clinical observation puts important constraints on the …
Cellular Effects Of Antiepileptic Drugs, Robert L. Macdonald, Michael A. Rogawski
Cellular Effects Of Antiepileptic Drugs, Robert L. Macdonald, Michael A. Rogawski
Michael A. Rogawski
Antiepileptic drugs (AEDs) protect against seizures through interactions with a variety of cellular targets, which include various ion channels, a neurotransmitter transporter, a neurotransmitter metabolic enzyme, and a synaptic vesicle protein. AED actions on these targets can be categorized into four broad groups: 1. Modulation of voltage-dependent ion channels (mainly sodium [Na] but also calcium [Ca] channels) 2. Effects on γ-aminobutyric acid (GABA) systems, including alterations in the cellular disposition of GABA and enhancement of synaptic inhibition mediated by GABA-A receptors 3. Inhibition of synaptic excitation mediated by ionotropic glutamate receptors 4. Modulation of neurotransmitter release, particularly of glutamate, through …