Vigabatrin in refractory childhood epilepsy. The Brazilian multicenter study

Children, 47, with various types of severe drug-resistant epilepsy were entered into a prospective, add-on, open trial with vigabatrin. Patients with West syndrome and idiopathic generalized epilepsies were excluded. Seven children had the drug withdrawn, five because of increase in seizure frequency and two because of adverse effects. Drug efficacy, measured according to seizure type, showed a 100% decrease in seizure frequency in 18.6% of partial seizures and 17.3% of the generalized seizures. There was a higher than 500% decrease in 39.5% of partial and 60.8% of generalized seizures, and less than 50% decrease or increase in seizure frequency in 41.8% and 21.8% of partial and generalized seizures, respectively. Vigabatrin mean dosage during phase 3 was 63.6 mg/kg per day (S.D. = 30.5), ranging from 19.3 to 110.5 mg/kg per day. Parametric statistical analysis (Student's t-test) of seizure frequency between phases 1 and 3 showed a significant decrease in seizure frequency for partial (P = 0.022), and generalized seizures (P < 0.0001). Drug-related adverse effects were observed in 18/47 cases (38.3%), consisting mainly of irritability, hyperactivity, dizziness, somnolence and gastrointestinal symptoms. (C) 1997 Elsevier Science B.V.2911

Como as crianças de 7 a 11 anos explicam sua cefaléia How children aged 7 to 11 explain their headache

O objetivo deste estudo foi observar a capacidade de crianças de 7 a 11 anos de idade em descrever sua cefaléia na anamnese. Para tanto, foram feitas duas avaliações de 94 crianças em entrevistas individuais pela mesma pediatra, com intervalo de seis a oito semanas, sem a presença de adultos. As características da dor de cabeça destas crianças puderam ser avaliadas nestas entrevistas, não havendo dados significativamente conflitantes entre as duas sessões. Embora habitualmente descrita e valorizada pelo adulto que acompanha a consulta, a cefaléia da infância deveria ser informada pelo próprio paciente. Neste grupo de crianças de 7 a 11 anos as informações foram obtidas sem dificuldade quando se permitiu à criança que usasse suas próprias palavras, no tempo que fosse necessário.<br>The aim of the present study was to observe the ability of children aged 7 to 11 in describing their headache during anamnesis. For this purpose, two evaluations of 94 children were performed in individual assessments, done by the same Pediatrician, within a six to eight week interval, without the presence of adults. The characteristics of headache in these children could be properly evaluated during the interviews. There were no remarkable conflicting information between the two interviews. Although the headache of the child is usually described by the accompanying adult during the consultation, childhood headache should really be informed by the patient. In this group of young children (7 to 11 years old), information could be obtained without difficulty since we allowed the child enough time and the use of his (her) own words