Effectiveness of piracetam in cortical myoclonus
Identifieur interne : 005D96 ( Main/Exploration ); précédent : 005D95; suivant : 005D97Effectiveness of piracetam in cortical myoclonus
Auteurs : P. Brown [Royaume-Uni] ; M. J. Steiger [Royaume-Uni] ; P. D. Thompson [Royaume-Uni] ; J. C. Rothwell [Royaume-Uni] ; B. L. Day [Royaume-Uni] ; M. Salama [Belgique] ; T. Waegemans [Belgique] ; Marsden [Royaume-Uni]Source :
- Movement Disorders [ 0885-3185 ] ; 1993.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Homme.
English descriptors
- KwdEn :
- Adult, Aged, Anticonvulsants (administration & dosage), Anticonvulsants (adverse effects), Cerebral Cortex (drug effects), Cerebral Cortex (physiopathology), Chemotherapy, Cortical myoclonus, Double-Blind Method, Drug Therapy, Combination, Electroencephalography (drug effects), Epilepsies, Myoclonic (drug therapy), Epilepsies, Myoclonic (physiopathology), Evoked Potentials, Somatosensory (drug effects), Evoked Potentials, Somatosensory (physiology), Female, Human, Humans, Male, Middle Aged, Myoclonus, Neurologic Examination (drug effects), Piracetam, Piracetam (administration & dosage), Piracetam (adverse effects), Treatment.
- MESH :
- chemical , administration & dosage : Anticonvulsants, Piracetam.
- chemical , adverse effects : Anticonvulsants, Piracetam.
- drug effects : Cerebral Cortex, Electroencephalography, Evoked Potentials, Somatosensory, Neurologic Examination.
- drug therapy : Epilepsies, Myoclonic.
- physiology : Evoked Potentials, Somatosensory.
- physiopathology : Cerebral Cortex, Epilepsies, Myoclonic.
- Adult, Aged, Double-Blind Method, Drug Therapy, Combination, Female, Humans, Male, Middle Aged.
Abstract
Twenty‐one patients with disabling spontaneous, reflex, or action myoclonus due to various causes, who had shown apparent clinical improvement on introduction of piracetam, entered a placebo‐controlled double‐blind crossover trial of piracetam (2.4– 16.8 g daily). All but one patient had electrophysiological evidence of cortical myoclonus. Patients were randomly allocated to a 14‐ day course of piracetam followed by identical placebo, or placebo followed by piracetam. Nineteen patients received piracetam/placebo in addition to their routine antimyoclonic treatment (carbamazepine, clonazepam, phenytoin, primidone, sodium valproate, or tryptophan plus isocarboxazid, alone or in combination) and two received piracetam/placebo as monotherapy. All patients were rated at the end of each treatment phase using stimulus sensitivity, motor, writing, functional disability, global assessment, and visual analogue scales. Ten of the 21 patients had to be rescued from the placebo phase of the trial because of a severe and intolerable exacerbation of their myoclonus. No patients required rescue from the piracetam phase of the double‐blind trial. When the 21 patients were considered together, there was a significant improvement in motor, writing, functional disability, global assessment, and visual analogue scores during treatment with piracetam compared with placebo. The total rating score also improved significantly with piracetam, by a median of 22%. Piracetam, usually in combination with other antimyoclonic drugs, is a useful treatment for myoclonus of cortical origin.
Url:
DOI: 10.1002/mds.870080112
Affiliations:
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Le document en format XML
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Brown</name><affiliation wicri:level="2"><country>Royaume-Uni</country><placeName><region type="country">Angleterre</region></placeName><wicri:cityArea>MRC Human Movement and Balance Unit and University Department of Clinical Neurology, Institute of Neurology, London</wicri:cityArea></affiliation></author><author><name sortKey="Steiger, M J" sort="Steiger, M J" uniqKey="Steiger M" first="M. J." last="Steiger">M. J. Steiger</name><affiliation wicri:level="2"><country>Royaume-Uni</country><placeName><region type="country">Angleterre</region></placeName><wicri:cityArea>MRC Human Movement and Balance Unit and University Department of Clinical Neurology, Institute of Neurology, London</wicri:cityArea></affiliation></author><author><name sortKey="Thompson, P D" sort="Thompson, P D" uniqKey="Thompson P" first="P. D." last="Thompson">P. D. 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Pharmaceutical Sector, Brainel 'Alleud</wicri:regionArea><wicri:noRegion>Brainel 'Alleud</wicri:noRegion></affiliation></author><author><name sortKey="Marsden" sort="Marsden" uniqKey="Marsden" last="Marsden">Marsden</name><affiliation wicri:level="2"><country>Royaume-Uni</country><placeName><region type="country">Angleterre</region></placeName><wicri:cityArea>MRC Human Movement and Balance Unit and University Department of Clinical Neurology, Institute of Neurology, London</wicri:cityArea></affiliation></author></analytic><monogr></monogr><series><title level="j">Movement Disorders</title><title level="j" type="sub">Official Journal of the Movement Disorder Society</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="1993">1993</date><biblScope unit="vol">8</biblScope><biblScope unit="issue">1</biblScope><biblScope unit="page" from="63">63</biblScope><biblScope unit="page" to="68">68</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">BB6FBD1E67637226BCE673AD93997113E3721EBD</idno><idno type="DOI">10.1002/mds.870080112</idno><idno type="ArticleID">MDS870080112</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged</term><term>Anticonvulsants (administration & dosage)</term><term>Anticonvulsants (adverse effects)</term><term>Cerebral Cortex (drug effects)</term><term>Cerebral Cortex (physiopathology)</term><term>Chemotherapy</term><term>Cortical myoclonus</term><term>Double-Blind Method</term><term>Drug Therapy, Combination</term><term>Electroencephalography (drug effects)</term><term>Epilepsies, Myoclonic (drug therapy)</term><term>Epilepsies, Myoclonic (physiopathology)</term><term>Evoked Potentials, Somatosensory (drug effects)</term><term>Evoked Potentials, Somatosensory (physiology)</term><term>Female</term><term>Human</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Myoclonus</term><term>Neurologic Examination (drug effects)</term><term>Piracetam</term><term>Piracetam (administration & dosage)</term><term>Piracetam (adverse effects)</term><term>Treatment</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Anticonvulsants</term><term>Piracetam</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Anticonvulsants</term><term>Piracetam</term></keywords><keywords scheme="MESH" qualifier="drug effects" xml:lang="en"><term>Cerebral Cortex</term><term>Electroencephalography</term><term>Evoked Potentials, Somatosensory</term><term>Neurologic Examination</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Epilepsies, Myoclonic</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Evoked Potentials, Somatosensory</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Cerebral Cortex</term><term>Epilepsies, Myoclonic</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Double-Blind Method</term><term>Drug Therapy, Combination</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Chimiothérapie</term><term>Homme</term><term>Myoclonie</term><term>Piracétam</term><term>Traitement</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Twenty‐one patients with disabling spontaneous, reflex, or action myoclonus due to various causes, who had shown apparent clinical improvement on introduction of piracetam, entered a placebo‐controlled double‐blind crossover trial of piracetam (2.4– 16.8 g daily). All but one patient had electrophysiological evidence of cortical myoclonus. Patients were randomly allocated to a 14‐ day course of piracetam followed by identical placebo, or placebo followed by piracetam. Nineteen patients received piracetam/placebo in addition to their routine antimyoclonic treatment (carbamazepine, clonazepam, phenytoin, primidone, sodium valproate, or tryptophan plus isocarboxazid, alone or in combination) and two received piracetam/placebo as monotherapy. All patients were rated at the end of each treatment phase using stimulus sensitivity, motor, writing, functional disability, global assessment, and visual analogue scales. Ten of the 21 patients had to be rescued from the placebo phase of the trial because of a severe and intolerable exacerbation of their myoclonus. No patients required rescue from the piracetam phase of the double‐blind trial. When the 21 patients were considered together, there was a significant improvement in motor, writing, functional disability, global assessment, and visual analogue scores during treatment with piracetam compared with placebo. The total rating score also improved significantly with piracetam, by a median of 22%. Piracetam, usually in combination with other antimyoclonic drugs, is a useful treatment for myoclonus of cortical origin.</div></front></TEI><affiliations><list><country><li>Belgique</li><li>Royaume-Uni</li></country><region><li>Angleterre</li></region></list><tree><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Brown, P" sort="Brown, P" uniqKey="Brown P" first="P." last="Brown">P. Brown</name></region><name sortKey="Day, B L" sort="Day, B L" uniqKey="Day B" first="B. L." last="Day">B. L. Day</name><name sortKey="Marsden" sort="Marsden" uniqKey="Marsden" last="Marsden">Marsden</name><name sortKey="Rothwell, J C" sort="Rothwell, J C" uniqKey="Rothwell J" first="J. C." last="Rothwell">J. C. Rothwell</name><name sortKey="Steiger, M J" sort="Steiger, M J" uniqKey="Steiger M" first="M. J." last="Steiger">M. J. Steiger</name><name sortKey="Thompson, P D" sort="Thompson, P D" uniqKey="Thompson P" first="P. D." last="Thompson">P. D. Thompson</name></country><country name="Belgique"><noRegion><name sortKey="Salama, M" sort="Salama, M" uniqKey="Salama M" first="M." last="Salama">M. Salama</name></noRegion><name sortKey="Waegemans, T" sort="Waegemans, T" uniqKey="Waegemans T" first="T." last="Waegemans">T. Waegemans</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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