Saturday, August 15, 2009

Epilepsy random pearls

1. Valproate works for tilt positive treatment (Eugene Ramsey)
2. Potential analogy of SUDEP and SIDS (failure of brainstem to respond to hypopnea (Mary Donner)
3. In VA study 80 % of patients had undiagnosed serious dyslipidemia, 70 % htn (Ramsey)
4. Asking patients if they turn hues esp. to shade of gray, almost certainly diagnoses NCS
5. Lamotrigine works extremely well for classic migraine (comorbid with epilepsy), less well for common migraine
6. Epilepsy patients describe panic attacks eloquently, but they may be unrecognized seizures (feeling in stomach, etc.)
7. Drug AE's are age related .
8. Carbamazepine causes weight gain, usually not recognized and may worsen tremor(Ramsey)
9. Topirimate helps BP, tremor, glucose control, weight
10. Ethosuximide worsens headache
11. PPI's raise gastric pH, making phenytoin absorption not happening
12. Stopping inducer, PHT or CBZ dramatically decreases clearance of LTG and TPM resulting in blood levels shooting up
13. Simvastatin levels go down 80 % with CBZ. Only statin not affected is ____/ Also beware of Calcium channel blockers (including nimodipine for SAH), HAART, drugs for ED

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