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Biomedical subjects

J Oxley

Publications and source records attributed to J Oxley.

At least 19 recordsLinked to original sources
PubMed1988

Socioeconomic accompaniments of severe epilepsy.

Limited quantitative research has been undertaken on the social accompaniments of severe epilepsy. In this study we present new data from 92 patients with uncontrolled seizures necessitating admission to a special assessment unit in the United Kingdom. Comprehensive information on the medical, educational, and social history of each subject was obtained; moreover, they completed the Social Problems Questionnaire, which examines the respondent's level of satisfaction with various aspects of living including employment, finances, housing, etc. Thirty-nine percent of the sample reported moderate or severe dissatisfaction in four problem areas. The most frequently reported problems were with social contacts (73%) and employment (71%). The significance of these findings is discussed and some remedial strategies outlined.

Adolescent↗
PubMed1986

The effect of lamotrigine, a novel anticonvulsant, on interictal spikes in patients with epilepsy.

Lamotrigine, a novel anticonvulsant, has been evaluated in patients with epilepsy using the method of interictal EEG spike counting. In a randomised double-blind trial it was found that oral lamotrigine (240 mg) was more effective than placebo, but less effective than diazepam (20 mg) in suppressing interictal spikes. Further clinical evaluation of lamotrigine is recommended in patients with epilepsy.

Adult↗
PubMed1986

A pharmacodynamic evaluation of midazolam as an antiepileptic compound.

Midazolam is a water soluble 1,4 benzodiazepine which is suitable for intramuscular administration. It is currently used for pre-medication and the induction of anaesthesia. Its antiepileptic properties have been evaluated by studying its effect on interictal spikes on the EEG of six adult epileptic patients. The results indicate that intramuscular midazolam 15 mg is more effective than intramuscular diazepam 10 mg in abolishing interictal spikes and as effective as intravenous diazepam 20 mg five minutes after administration.

Adult↗
PubMed1985

Clinical evaluation of 4-channel ambulatory EEG monitoring in the management of patients with epilepsy.

The role of 4-channel EEG taped monitoring in the management of patients with severe epilepsy has been evaluated, by examining the recordings from 100 consecutive patients referred for monitoring. Six main reasons for referral have been identified and in 80% of subjects the relevant clinical event was recorded, leading directly to a change in treatment in 57% of cases. This technique has proved to be cost effective and reliable and is particularly valuable in the identification of pseudo seizures.

Adolescent↗
PubMed1984

Single dose pharmacokinetic study of clobazam in normal volunteers and epileptic patients.

The pharmacokinetics of clobazam were studied in six healthy volunteers and six age and sex matched enzyme-induced epileptic patients. In the epileptic patients the area under the plasma concentration-time curve for clobazam was significantly smaller and the area under the plasma concentration-time curve for N-desmethylclobazam was significantly greater than in the healthy volunteers. Plasma N-desmethylclobazam concentrations were found to be much higher than those of clobazam in the epileptic patients, raising the possibility that the antiepileptic properties of clobazam are to be attributed more to its metabolite than the parent drug.

Adolescent↗
PubMed1984

Pituitary responsiveness to gonadotrophin-releasing and thyrotrophin-releasing hormones in epileptic patients receiving carbamazepine or phenytoin.

Pituitary responsiveness to gonadotrophin-releasing (LHRH) and thyrotrophin-releasing (TRH) hormones was studied in 19 epileptic patients receiving long-term carbamazepine or phenytoin therapy and 14 normal control subjects. Baseline prolactin levels were normal in the patients; 2h after LHRH-TRH the prolactin levels in women on carbamazepine were significantly higher than in the controls, but apart from this, no other differences were found. Baseline LH levels were raised in male patients and the response to LHRH-TRH was exaggerated in all patients on carbamazepine. FSH levels were normal throughout. The exaggerated LH response is consistent with primary hypogonadism caused by enhanced sex hormone metabolism, secondary to hepatic enzyme induction by the antiepileptic drugs.

Adult↗
PubMed1984

A clinical trial of single dose rectal and oral administration of diazepam for the prevention of serial seizures in adult epileptic patients.

The clinical anticonvulsant efficacy of single dose rectal and oral administration of diazepam 20 mg was examined in two double-blind placebo-controlled trials in adult epileptic patients. All subjects suffered from drug resistant epilepsy and frequently experienced serial seizures. Diazepam was administered rectally as a new experimental suppository formulation immediately after a seizure and was highly effective in preventing recurrent fits within a 24 h observation period (p less than 0.001). Pharmacokinetic studies revealed a wide range of serum diazepam concentrations 60 min after administration of the suppository (mean serum diazepam level 190 +/- 73 (SD ng/ml). In a similar study oral administration of diazepam 20 mg significantly reduced the incidence of serial seizures compared with a placebo (p less than 0.01) and the mean 60 min serum diazepam level was 273 +/- 190 (SD) ng/ml.

Administration, Oral↗
PubMed1983

Acute effects of intravenous phenytoin on the frequency of inter-ictal spikes in man.

Phenytoin was administered intravenously to six adult epileptic patients in doses ranging from 500--1000 mg (equivalent to 5.6 mg/kg--20 mg/kg body weight). A significant decrease in the frequency of inter-ictal spikes in the EEG was seen and this effect was most marked 10--20 min after the infusion, when the mean spike count was reduced to 27% (s.d. 17%) of the control (P less than 0.05). In one subject the decrease in inter-ictal spikes coincided with a decrease in fit frequency. Adverse reactions affecting the vestibular system occurred in three patients at doses of 15--20 mg/kg. No cardiovascular complications were observed in any subject. The overall results suggest that doses of 7.5--10 mg/kg would be sufficient to significantly reduce the frequency of inter-ictal spikes in the EEG.

Adult↗
PubMed1983

A controlled trial of cinromide.

A double-blind controlled trial of cinromide in 25 adult subjects with refractory epilepsy using the maximum tolerated dose showed that it possessed no significant antiepileptic properties.

Adolescent↗
PubMed1983

Prolactin and gonadotrophin changes following generalised and partial seizures.

Postictal values of prolactin, LH and FSH have been recorded in patients with both generalised tonic-clonic and partial seizures. Elevations of prolactin and LH were seen immediately and at 20 minutes in males and females with generalised attacks. At sixty minutes values for prolactin had fallen to baseline levels, but LH remained elevated. FSH values were increased in females only, at twenty and sixty minutes. Following partial seizures prolactin was elevated, especially with complex partial seizures, at twenty minutes. These results are discussed in the light of known electrophysiological mechanisms relating to partial seizures, and clinical guidelines for the use of neurohormonal tests in the evaluation of seizures are suggested.

Consciousness↗
PubMed1982

Bioavailability of diazepam after intravenous, oral and rectal administration in adult epileptic patients.

1 The absorption of single doses of diazepam in six adult epileptic subjects following intravenous, oral and rectal administration were studied in order to evaluate the usefulness of the latter in emergency situations in the adult. 2 Diazepam tablets (Valium, Roche) and rectal solution (Valium solution for intravenous administration) produced similar peak serum concentrations after delays of 15-90 min. 3 Two suppository formulations showed statistically significant differences in absorption characteristics. 4 Serum diazepam levels above 400 ng ml-1 (suggested to be necessary for a satisfactory anticonvulsant effect) were reached in only a few subjects after rectal doses of 10-20 mg of solution, and then usually after a delay of over 2 h.

Administration, Oral↗
PubMed1982

Absorption of diazepam from the rectum and its effect on interictal spikes in the EEG.

Rectal administration of several different preparations of diazepam to a group of adult volunteer patients with epilepsy produced variable rates of absorption. Peak serum concentrations following 10 mg, 20 mg, and 30 mg of diazepam solution were achieved between 13-60 min, 10-120 min, and 30-90 min respectively. An experimental diazepam "solid solution" suppository was found to have significantly better absorption characteristics compared with the commercially available Valium suppository. Diazepam solution 20 mg was administered rectally in 10 adult epileptic patients with frequent spontaneous interictal spikes in their EEGs. A highly significant reduction in spike frequency was seen compared with placebo. The effect was most marked 10-20 min after administration of diazepam, when the mean spike count fell to 39 +/- 35 SD percent of the control value (p less than 0.01), and this corresponded with a mean serum diazepam level of 210 +2- 125 ng/ml.

Adolescent↗