RESUMEN
OBJECTIVE: To investigate the effects of fluoxetine in migraine prophylaxis on habituation of visually evoked potentials. BACKGROUND: Habituation of pattern reversal visually evoked potentials was found to be abnormal in migraine between attack, and this abnormality was most likely due to serotonergic pathway dysfunction in the brain stem. METHODS: One hundred nineteen subjects were included in the study: 40 healthy volunteers and 79 migraineurs not taking any prophylactic migraine medication (44 without aura and 35 with aura). Visually evoked potentials in migraineurs were recorded in the headache-free interval. Amplitude change of the visually evoked potentials (N1-P1) was measured between the first and fifth block of 50 sequential averagings during continuous stimulation at 3.1 Hz. All migraineurs were placed on fluoxetine 20 mg/day for prophylaxis of migraine. One month later, visually evoked potentials were recorded again. RESULTS: Mean amplitude changes in the fifth block expressed as percentages of the first block were -13.4% +/- 19.2% in healthy volunteers, 9.8% +/- 23.3% in migraine without aura, and 4.4% +/- 8.7% in migraine with aura during the baseline period. The difference was significant between migraineurs and healthy volunteers (both P= 0.0001), but not between migraineur groups. After treatment, amplitude changes were -9.3% +/- 14.5% in migraine without aura and -10.1% +/- 11.5% in migraine with aura. Habituation pattern tended to normalize with prophylactic treatment, and mean amplitude changes were not significant between migraineurs and healthy volunteers (both P = 0.4). CONCLUSIONS: We concluded that the fluoxetine prophylaxis corrects the interictal deficit of habituation in migraineurs.
Asunto(s)
Potenciales Evocados Visuales/efectos de los fármacos , Fluoxetina/farmacología , Habituación Psicofisiológica/efectos de los fármacos , Trastornos Migrañosos/prevención & control , Inhibidores Selectivos de la Recaptación de Serotonina/farmacología , Adulto , Femenino , Fluoxetina/efectos adversos , Fluoxetina/uso terapéutico , Humanos , Masculino , Trastornos Migrañosos/fisiopatología , Náusea/inducido químicamente , Inhibidores Selectivos de la Recaptación de Serotonina/efectos adversos , Inhibidores Selectivos de la Recaptación de Serotonina/uso terapéutico , Fases del Sueño/efectos de los fármacos , Resultado del TratamientoRESUMEN
UNLABELLED: To evaluate central nervous system functioning involvement in nocturnal enuresis, P300 and N200 event-related brain potentials and brainstem auditory-evoked potentials (BAER) were assessed in a group of 35 enuretic boys aged 7-9 years. The measurements of enuretic group were compared to those of age and sex matched non-enuretics. P300 latency in the enuretic group was significantly longer than in non-enuretic group (420 ms at parietal scalp (Pz), 414 ms at central scalp (Cz) versus 386 ms at Pz, 376 ms at Cz; P < 0.01 and P < 0.01, respectively). Both enuretic and non-enuretic subjects were divided into three subgroups his age. There was no significant difference in terms of both P300 amplitude and N200 latency and N200 amplitude between non-enuretic age subgroups. But, P300 latency over central scalp in 8 years old non-enuretic subgroup was significantly longer than in 9 years old non-enuretic subgroup (P < 0.01). No significant difference was found in latency and amplitude of P300 and N200 latency between enuretic subgroups. However, N200 amplitude at Cz in 8 years old enuretic subgroup was significantly lower than both in 7 years old enuretic subgroup and in 9 years old enuretic subgroup (P < 0.01 and P < 0.01, respectively). There were significant topographical differences in latency and amplitude of P300 and in N200 latency in enuretic age subgroups, only. There was no significant difference in interpeak latencies I-III, I-V and III-V and wave latencies I, III and V of BAERs between enuretic group and non-enuretic subgroup. Longer interpeak and wave latencies of BAERs were found both in 8 years old enuretic subgroup and 8 years old non-enuretic subgroup. CONCLUSION: Longer P300 latency in primer enuretics compare to non-enuretics is an evidence of a maturational delay of central nervous system functioning.
Asunto(s)
Enuresis/fisiopatología , Potenciales Evocados Auditivos del Tronco Encefálico/fisiología , Potenciales Evocados/fisiología , Factores de Edad , Niño , Electroencefalografía , Potenciales Relacionados con Evento P300/fisiología , Humanos , MasculinoRESUMEN
Gamma-aminobutyric acid-induced ion transport changes in the retinal pigment epithelium are described. Valproate acts as an inhibitor of gamma-aminobutyric acid transaminase. The purpose of this study was to investigate whether early visual impairment is related to valproate in patients with and without visual symptoms. Thirty-two patients, presenting with a history of seizures currently being treated with valproate, were included in the study. A complete clinical neuroophthalmologic examination was performed, including electroretinogram and visual field test. The electroretinogram parameters of epileptic patients were compared with those of 28 age- and sex-matched healthy volunteers. There was no significant difference in ERG parameters between the two groups. The visual field and visual acuity of all patients were within normal limits. When valproate is not used in conjunction with other antiepileptic drugs and serum levels are within therapeutic levels, it does not cause electrophysiologically detectable retinal dysfunction or any functional defect in visual perception that can be determined clinically.