Effectiveness of piracetam in cortical myoclonus.
Identifieur interne : 004C60 ( PubMed/Checkpoint ); précédent : 004C59; suivant : 004C61Effectiveness of piracetam in cortical myoclonus.
Auteurs : P. Brown [Royaume-Uni] ; M J Steiger ; P D Thompson ; J C Rothwell ; B L Day ; M. Salama ; T. Waegemans ; C D MarsdenSource :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 1993.
English descriptors
- KwdEn :
- Adult, Aged, Anticonvulsants (administration & dosage), Anticonvulsants (adverse effects), Cerebral Cortex (drug effects), Cerebral Cortex (physiopathology), 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, Humans, Male, Middle Aged, Neurologic Examination (drug effects), Piracetam (administration & dosage), Piracetam (adverse effects).
- 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.
DOI: 10.1002/mds.870080112
PubMed: 8419809
Affiliations:
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<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>
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<Abstract><AbstractText>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.</AbstractText>
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