187 results on '"H. Meinardi"'
Search Results
2. Contributors
- Author
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Jorge J. Asconapé, Jacques Bruinvels, Raymond G. Hill, Graham A.R. Johnston, Wolfgang Jost, Francisco López-Muñoz, Michael J. Parnham, Gary Remington, Peter Riederer, Dan Rujescu, Mary V. Seeman, Zénon M. Bacq, C.D. Binnie, Arvid Carlsson, Pierre Deniker, Serge Gauthier, Willy Haefely, Peter Holzer, P.A.J. Janssen, Nathan S. Kline, Heinz E. Lehmann, Fred Lembeck, J.W.A. Meijer, H. Meinardi, R. Mishra, Theodore L. Sourkes, F. Sulser, J.P. Tollenaere, and E. Albert Zeller
- Published
- 2023
- Full Text
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3. Development of diagnostic reference frames for seizures. Part 2: are seizure descriptions discriminative?
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J. F. van Ast, Jan L. Talmon, W. O. Renier, H. Meinardi, P. P. M. Ahles, and Arie Hasman
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- 2003
- Full Text
- View/download PDF
4. Validating a decision support system for anti-epileptic drug treatment: Part I: initiating anti-epileptic drug treatment.
- Author
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R. Smeets, Jan L. Talmon, H. Meinardi, and Arie Hasman
- Published
- 1999
- Full Text
- View/download PDF
5. Validating a decision support system for anti-epileptic drug treatment: Part II: Adjusting anti-epileptic drug treatment.
- Author
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R. Smeets, Jan L. Talmon, H. Meinardi, and Arie Hasman
- Published
- 1999
- Full Text
- View/download PDF
6. Epilepsie
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A. P. Aldenkamp, A. Martins da Silva, and H. Meinardi
- Published
- 2017
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7. Clinical Pharmacology of Anti-Epileptic Drugs : Workshop on the Determination of Anti-Epileptic Drugs in Body Fluid II (WODADIBOF II) Held in Bethel, Bielefeld, Germany, 24 - 25 May, 1974
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H. Schneider, D. Janz, C. Gardner - Thorpe, H. Meinardi, A. L. Sherwin, H. Schneider, D. Janz, C. Gardner - Thorpe, H. Meinardi, and A. L. Sherwin
- Subjects
- Pharmacology, Pharmacy, Medical sciences
- Abstract
'He who is faithfully analysing... epi lepsy is doing far more than studying epilepsy'Hughlings Jackson Modifying this well-known statement by Jackson, one could say today:'He who is faithfully analysing anti-epileptic drugs is doing far more than studying anti-epileptic drugs'. For these drugs not only serve to prevent epileptic fits and thus advance the treatment of epilepsy, they are also effective in the treatment of cardiac arrhythmias and trigeminal neuralgia. Furthermore, clinical pharmacologists consider anti-epi leptic drugs as model drugs in pharmacokinetics and pharmocodynamics, since reliable methods are available for their determination and their effects and side effects can be defined. The methods of estimating of drugs in body fluids provide a tool that enables us to throw light on many obscure relationships in pharmaceutical treatment. Now that we can study the pharmacokinetics and interaction of drugs in man, many hypotheses based on clinical experience alone may well be eliminated or corroborated. The grow ing body of knowledge will make us more careful about the administration of drugs in combination. Now that we can study how biological parameters interfere with drug action, we may perhaps proceed to the scientific analysis of many clinical observations that suggest the importance of such factors as age, sex, menstrual cycle, pregnancy, fever, diet, stress, sport, climate, and altitude.
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- 2012
8. Epilepsy in the Tropics: I. Epidemiology, Socioeconomic Risk Factors, and Etiology
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N Senanayake, R Shakir, H Meinardi, Arturo Carpio, Michel Dumas, M A Danesi, O H Cossio, J Sotelo, P R M De Bittencourt, Nadir E. Bharucha, A Ordinario, and B Adamolekum
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medicine.medical_specialty ,Global Health ,Epilepsy ,Risk Factors ,Tropical Medicine ,Environmental health ,Tropical climate ,Epidemiology ,Prevalence ,Global health ,Humans ,Medicine ,Risk factor ,Developing Countries ,Socioeconomic status ,Tropical Climate ,business.industry ,Age Factors ,Tropics ,medicine.disease ,Surgery ,Neurology ,Etiology ,Neurology (clinical) ,business - Published
- 1996
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9. Fourth meeting of the European Neurological Society 25–29 June 1994 Barcelona, Spain
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H. Hattig, C. Delli Pizzi, M. C. Addonizio, Michelle Davis, A. R. Giovagnoli, L. Florensa, M. Roth, J. de Kruijk, Francisco Lacruz, Ph. Dewailly, A. Toygar, C. Avendano, P.P. De Deyn, J. F. Hurtevent, F. Lomeila, T. W. Wong, Gordon T. Plant, M. Bud, H. J. Willison, DH Miller, D. W. Langdon, R. Cioni, J. Servan, A. Kaygisiz, E. Racadot, D. B. Schens, E. Picciola, L. Falip, C. Bouchard, J. Jotova, A. Jorge-Santamaria, P. Misra, A. Dufour, C. P. Panagopoulos, A. Venneri, B. Sredni, B. Angelard, M. Janelidze, M. Carreno, J. Obenberger, J. Pouget, H. W. Moser, R. Kaufmann, J. A. Molina, D. Linden, A. Martin Urda, E. Uvestad, A. Krone, J. P. Cochin, J. Mallecourt, A. Cambon-Thomsen, K. Violleau, P. Osschmann, A. M. Durocher, E. Bussaglia, D. M. Danielle, H. Efendi, C. Van Broeckhoven, K. G. Jordan, W. Rautenberg, C. Iniguez, J. M. Delgado, Graham Watson, M. Lawden, Gareth J. Barker, K. Stiasny, James T. Becker, G. Campanella, E. Peghi, A. Poli, A. Haddad, T. Yamawaki, Giacomo P. Comi, S. Sotgiu, B. Ersmark, A. Pomes, M. Ziegler, P. Ferrante, P. Ruppi, H. KuÇukoglu, R. Bouton, U. K. Rinne, P. Vieregge, M. Dary, P. Giunti, Peter J. Goadsby, S. Jung, E. Secor, A. Steinberg, N. Vila, M. A. Hernandez, M. Cursi, A. Enqelhardt, A. Engelhardt, J. Veitch, F. Di Silverio, F. Arnaud, B. Neundörfer, R. Brucher, Dominique Caparros-Lefebvre, B. Meyer, Marianne Dieterich, M. H. Snidaro, R. Gomez, R. Cerbo, M. Ragno, J. M. Vance, S. Nemni, A. Caliskan, F. Barros, I. Velcheva, D. Ceballos-Baumann, V. Barak, A. Avila, N. Antonova, F. Resche, S. Pappata, L. Varela, S. R. Silveira Santos, A. Cammarota, L. Naccache, Y. Nara, E. Tournier-Lasserves, R. Mobner, T. Chase, A. Ensenyat, J. Ulrich, G. Giegerich, M. Rother, M. Revilla, N. Nitschke, K. Honczarenko, E. Basart Tarrats, J. Blin, B. Jacob, J. Santamaria, S. Knezevic, J. L. Castillo, M. Antem, J. Colomer, O. Busse, Didier Hannequin, S. Carrier, J. B. Ruidavets, C. Rozman, J. Bogoussslavsky, J. Pascual Calvet, E. Monros, J. M. Polo, M. Zucconl, Javier Muruzabal, R. R. Allen, R. Rivolta, K. Haugaard, A. Nespolo, K. Hoang-Xuang, G. Bussone, T. Avramidis, E. Corsini, Christiana Franke, T. Vinogradova, H. Boot, K. Vestergaard, G. H. Jansen, N. Argentino, M. Raltzig, W. Linssen, Mark B. Pepys, P. Roblot, L. Lauritzen, E. Fainardi, D. Morin, T. X. Arbizu Urdiain, J. Wollenhaupt, S. Bostantjopoulou, G. Pavesi, A. D. Forman, Giovanni Fabbrini, D. Jean, J. J. Archelos, M. I. Blanchs, M. Del Gobbo, Anna Carla Turconi, Ch. Derouesné, Elio Scarpini, A. Visbeck, P. Castejon, J. P. Renou, F. Mounier-Vehier, G. Potagas, Ch. Duyckaerts, A. Filla, R. Schneider, G. Ronen, K. Nagata, J. P. Vedel, A. Henneberg, G. van Melle, C. Baratti, H. Knott, M. C. Prevett, A. Bes, B. Metin, Jos V. Reempts, L. Martorell, Mefkure Eraksoy, H. O. Handwerker, D. S. Younger, O. Oktem, D. Frongillo, C. Soriano-Soriano, L. Niehaus, F. Zipp, A. Tartaro, S Newman, R. H. Browne, P. Davous, R. Sanchez, M. Muros, M. E. Kornhuber, A. Lavarone, M. Mohr, M. R. Garcia, S. Russell, H. Kellar-Wood, M. R. Tola, B. Ostermeyer, Ch. Tzekov, K. Sartor, E. B. Ringelstein, P. P. Gazzaniga, Paul Krack, H. Fidaner, H. Rico, T. Dbaiss, F. Alameda, E. Torchiana, L. Rumbach, I. Charques, J. M. Bogaard, C. D. Frith, L. J. Rappelle, R. Brenner, A. Joutel, K. Fuxe, G. HÄcker, M. J. Blaser, J. Valls-SolÇ, G. Ulm, M. Alberdi, A. Bock, F. W. Bertelsmann, U. Wieshmann, J. Visa, J. R. Lupski, D. D'Amico, L. M. P. Ramos, A. A. Vanderbark, R. Horn, M. Warmuth, Dietmar Kühne, Mark S. Palmer, C. Ehrenheim, E. Canga, S. Viola, O. Scarpino, P. Naldi, R. Almeida, A. A. Raymond, J. Gamez, Stephan Arnold, A. DiGiovanni, J. Dalmau, C. C. Chari, H. F. Beer, J. C. Koetsier, J. Iriarte, E. Yunis, J. Casadevall, E. Le Guern, E. Stenager, S. R. Benbadis, J. M. Warter, F. Burklin, I. Theodorou, L. Johannesen, G. A. Graveland, X. Leclerc, I. Vecchio, L. Ozelius, G. Nicoletti, R. K. Gherardi, E. Esperet, M. L. Delodovici, F. Cattin, F. Paiau, Giorgio Sacilotto, C. A. J. Broere, D. Chavdarov, J. P. Willmer, C. H. Hawkes, Th. Naegele, E. Ellie, E. Dartigues, M. J. Guardiola, S. Hesse, Z. Levic, Marco Rovaris, P. Saugeir-Veber, B. A. Yaqub, H. F. Durwen, R. Larumbe, J. Ballabrina, M. Sendtner, J. Röther, M. Horstink, C. Kluglein, M.P. Montesi, H. Apaydin, J. Montoya, E. Waubant, Ch. Verellen-Dunoulin, A. Nicolai, J. Lopez-Delval, R. Lemon, G. Cantinho, E. Granieri, A. Zeviani, Wolfgang H. Oertel, U. Ficola, V. Di Piero, V. Fragola, K. Sabev, M. V. Guitera, I. Turki, F. Bolgert, P. Ingrand, J. M. Gobernado, L. M. E. Grimaldi, S. Baybas, B. Eymard, Y. Rolland, Y. Robitaille, Ta. Pampols, P. J. Koehler, A. Carroacedo, J. Vilchez, S. Di Vittorio, I. R. Rise, T. Nagy, M. Kuffner, E. Palazzini, A. Ott, J. Pruim, T. X. Arbizu, E. Manetti, C. Cervera, S. Felber, G. Gursoy, J. Scholz, G. A. Buscaino, M. S. Chen, A. Pascual, J. Hazan, J. U. Gajda, J. G. Cea, G. Bottini, G. Damalik, F. Le Doze, G. Bonaldi, J. M. Hew, C. Messina, A. M. Kennedy, J. M. Carney, N. M. F. Murray, M. Parent, M. Koepp, V. Dimova, D. De Leo, K. Jellinger, G. Salemi, S. Mientus, M. L. Hansen, F. Mazzucchelli, J. Vieth, M. Mauri, E. Bartels, L. Johannsen, C. Humphreys, J. Emile, D. N. Landon, E. Kansu, R. Sanchez-Pernaute, Rsj Frackowiak, M. Gonzalez Torres, L. Oller, C. Machedo, J. Kother, M. Billiard, H. Durak, T. Schindler, A. Frank, A. Uncini, A. Sbriccoli, C. Farinas, D. W. Paty, N. Fast, A. T. Zangaladze, A. Kerkhofs, J. M. Pino Garcia, I. De la Fuente, B. Marini, L. Gomez, I. Rubio, Alessandra Bardoni, C. Brodie, P. Acin, U. Sliwka, S. A. Hawkins, S. Tardieu, F. Vitullo, J. M. Pereira Monteino, R. Gagliardi, T. Jezewski, A. Cano, T. Lempert, F. Abad Alegria, G. Rotondo, D. Ince, C. Martinez Parra, Y. Huang, H. Luders, Y. Steinvil, F. G. A. Van Der Meche, R. Bianchi, A. Sanchez, T. Sevilla, J. M. Ketelslegers, A. Domzal-Stryga, M. Pandolfo, M. O. Josse, K. W. Neff, I. Blanco, G. W. Bruyn, O. W. Witte, J. L. Thibault, G. Andersen, J. Pariset, A. Marcone, R. J. M. Lane, A. Hofman, M. Verin, T. Matilla, P. Bedoucha, J. Roche, M. Lai, M. Collard, A. Ugarte, F. Gallecho, D. Silbersweig, C. Kennard, J. P. Azulay, T. W. Ho, P. L. I. Dellemijn, R. Girardello, F. Baas, B. Voss, F. Rozenberg, E. M. Brocker, V. Stanev, A. A. J. Soeterboek, A. Marra, A. Rey, E. Ertem, M. Sawradewicz-Rybak, J. De Keyser, P. Cavallari, F. Proust, Y. Chevalier, H. C. Hansen, D. Leys, C. A. Davie, K. Hoang-Xuan, C. Bairati, H. van Crevel, Thomas T. Warner, B. Bompais, A. Dobbeleir, T Campbell, C. Macko, C. J. M. Klijn, M. Dussallant, T. P. Berlit, W. Rozenbaum, M. J. van den Bent, W. A. Rocca, M. Muller, H. Hundemer, U. Zifko, M. Campera, F. Drislane, D. Ranoux, T. M. Kloss, Anil Kumar, I. Ruolt, C. Bargnani, B. Marescau, N. A. Losseff, S. Notermans, B. Kint, E. T. Burke, C. Aykut, J. Matias Guiu, P. Maquet, T. Drogendijk, M. Leone, K. von Ammon, M. Pepeliarska, C. Prados, L. DiGiamberardino, T. Logtenberg, G. Lenoir, I. Castaldo, Damhaut, M. Radionova, G. Sirabian, R. Navon, Giovanni Antonini, K. Al Moutaery, E. Chamas, R. Schönhuber, M. Giannini, B. Debilly, I. Labatut, H. Henon, J. A. Egido, M. Baudrimont, J. N. Lorenzo, J. E. C. Bromberg, R. Antonacci, J. J. Vilchez, T. Moulin, B. Rautenstrauss, Giovanni Meola, J. Noth, S Mammi, P. Laforet, F. Lopez, C. Gehring, S. Bort, G. Rancurel, D. Decamps, S. Kostadinova, Y. Shapira, B. Neundoerfer, D. Chavrot, M. Solimena, J. P. Salier, W. Deberdt, R. Hoff-Jörgensen, A. Messina, S. Meairs, G. Rosoklija, E. Nelis, I. Bertran, C. Ertekin, J. Lohmeyer, Mitermayer Galvao dos Reis, L. Calo, E. Maccagnano, A. P. Hays, J. Verlooy, M. G. Forno, T. Blanco, L. Bail, Gabriella Silvestri, J. Montero, F. Bertrand, R. T. Ghnassia, C. Besses, T. Sereghy, F. Shalit, G. Bogliun, S. Braghi, St. Baykouchev, C. Franke, A. Lasa, L. C. Archard, J. Kriebel, S. Shaunak, M. Nocito, Alexander Tsiskaridze, E. Manfredini, T. Seigal, David G. Gadian, M. Barlas, J. D. Degos, C. Seeber, J. Caemert, J. L. Mas, R. B. Pepinsky, M. G. D'Angelo, N. Baumann, S. Yorifuji, H. P. Endtz, M. A. Cassatella, R. A. C. Hughes, V. Golzi, A. Bittencourt, A. Ferreira, M. Sanson, C. Alper, M. Vermeulen, M. A. A. van Walderveen, E. Alexiou, C. H. Lucas, M. Fiorelli, Y. N. Debbink, R. Gil, S. Congia, T. Banerjee, J. M. Bouchard, A. N. Pinto, A. Ceballos-Baumann, G. Grollier, P. I. M. Schmitz, M. D. Catata, N. Lahat, N. S. Rao, P. Papathanasopoulos, J. Valls-Solé, D. Claus, G. Schroter, A. Castro, C. Videbaek, R. Martinez Dreke, A. D. Platts, M. Hermesl, A. C. PeÇanha-Martins, M. Cardoso Silva, P. Masnou, M. J. A. Tanner, Ch. Confavreux, B. Mishu, H. Rasmussen, L. Valenciano, Carlo Pozzilli, S. W. Li, V. Salzman, Y. Vashtang, Massimo Franceschi, M. Severo, G. Deuschl, S. Setien, G. Mariani, A. Protti, J. Castillo, M. J. B. Taphoorn, M. Frontali, I. Milonas, D. Decoq, J. A. Navarro, S. Castellvi-Pel, C. Ertikin, M. Urtasun, Y. Lajat, B. E. Kendall, E. Verdu, B. Gueguen, E. Boisen, R. Couderc, A Danek, JM Stevens, F. Nicoli, L. Feltri, M. L. Vazquez-Andre, J. A. Morgan-Hughes, L. D'Angelo, F. Y. Liew, L. F. Pascual, J. Patrignani Ochoa, Vittorio Martinelli, J. Cophignon, L. Zhang, S. Martin, J. F. Meder, H. C. Buschmann, L. Bertin, J. van Gijn, A. Barreiro, A. Cools, C. Leon, A. Berod, E. A. Anllo, E. Zanette, L. Petrov, R. Barona, B. Gallicchio, P. J. Cozzone, N. Diederich, G. Cancel, L. Schelosky, P. Orizaola, K. Yulug, S. Ozer, Valeria A. Sansone, B. Guiraud-Chaumeil, K. Voigt, P. Labauge, M. Eoli, J. Zhu, J. Aguirre, M. Ferrarini, B. Zyluk, E. Planas, A. Cadilha, C. Tortorella, H. Bismuth, C. E. Counsell, A. Laun, A. Ferlini, Rio J. Montalban, N. Biary, L. Becker, M. Fardeau, M. Poloni, V. M. S. de Bruin, C. Fornada, J. Barros, E. Ganzmann, E. Touze, D. Wallach, J. Peila, H. Fujimura, M. T. Iba-Zizen, G. Macchi, C. Villoslada, R. Gouider, Ph. Rondepierre, P. Grummich, P. Chiodi, C. Conte, M. Michels, P. Annunziata, G. Semana, C. Sommer, J. Vajsar, D. Zekin, J. Kulisevsky, David G. Munoz, B. Jacotot, M. Magoni, A. Luxen, T. Garcia-Silva, S. Di Cesare, Christophe Tzourio, M. Gomori, I. Picomell, L. Santoro, F. Villa, Giovanni Pennisi, T. Ribalta, J. M. Molto, L. Marzorati, P. Loiseau, F. Gemignani, A. Gironell, J. Wissel, A. Prusinski, F. Cailloux, P. Villanueva-Hemandez, P. Cozzone, T. Del Ser, J. Sans-Sabrafen, M. Zappia, P. W. A. Willems, G. Tchernia, D. Gardeur, R. Bauer, F. Palomo, H. Metz, S. Lamoureux, C. Chastang, I. Reinhard, A. Goldfarb, S. Harder, Jordi Río, C. Ozkara, E. Tekinsoy, P. Vontobell, J. De Recondo, M. Rabasa, L. Lacomblez, F. Boon, Dgt Thomas, V. Palma, Renato Mantegazza, A. Dervis, M. Nueckel, B. YalÇinerner, I. Duran, G. Dalla Volta, A. Zubimendi, J. Pinheiro, A. Marbini, Xavier Montalban, H. Wekerle, X. Pereira Monteino, F. Crespo, F. Koskas, N. Battistini, C. Ruiz, H. Offner, J. de Pommery, P. Kanovsky, J. Y. Barnett, J. Pardo, G. Tomei, R. Rene, H. M. Lokhorst, P. Thajeb, H. Bilgin, D. McGehee, R. Fahsold, L. Morgante, Katie Sidle, C. Delwaide, M. N. Diaye, P. H. Rice, A. Creange, C. Sabev, K. Stephan, K. WeilBenborn, G. Magnani, L. Grymonprez, F. Cardellach, M. Kaps, N. G. Meco, F. Vega, V. Bonifati, A. Desomer, M. Baldy-Moulinier, G. Kvale, F. J. Authier, B. Yegen, T. Ho, J. M. Rozet, E. A. Cabanis, L. Bruce, L. Ambrosoli, M. A. Petrella, M. Hernandez, P. Timmings, H. B. van der Worp, F. Mahieux, A. Urbano-Marquez, D. A. Krendel, A. A. Garcia, R. Divari, R. Michalowicz, M. R. Piedmonte, M. Bondavalli, M. Zanca, P. F. Ippel, Onofre Combarros, B. Tavitian, E. Hirsch, I. Anastasopoulos, A. Roses, A. Köhler, P. Vienna, V. Timmerman, P. Sergi, F. Cornelio, A. Di Pasquale, R. Verleger, S. Castellvirel, J. Proano, B. van Moll, F. Rubio, W. Hacke, I. Lavenu, L. Zetta, M. W. Tas, N. Bittmann, M. Bonamini, O. R. Hommes, V. Dousset, N. Afsar, S. Belal, R. R. Myers, J. Goes, Giuseppe Vita, E. Clementi, V. G. Karepov, M. Jueptner, A Vincent, P. Emmrich, Th. Heb, A. Caballo, J. Gallego, T. Mokrusch, C. Perla, L. Gebuhrer, O. Titlbach, Alessandro Prelle, A. Czlonkowska, M. Russo, D. Hadjiev, T. S. Chkhikvishvili, M. Oehlschlager, G. Becker, I. Günther, E. N. Stenager, J. Garcia Agundez, J. Casademont, J. Batlle, S. Podobnik-Sarkanji, C. Alonso-Villaverde, B. Delaguillaume, B. Genc, B. Mazoyer, A. Rodriguez-Al-barino, Ch. Hilger, B. Ferrero, R. Price, W. Grisold, L. Fuhry, D. Oulbani, D. Ewing, A. Petkov, W. Walther, A. Gokyigit, John Newsom-Davis, J. Tayot, D. Seliak, G. Pelliccioni, D. Campagne, K. Kessler, F. Boureau, D. Perani, J. P. N'Guyen, N. Tchalucova, B. A. Antin-Ozerkis, C. Lacroix, B. D. Aronovich, I. H. Jenkins, E. A. dos Reis, M. Hortells, H. M. Meinck, H. Ch. Buschmann, S. C. J. M. Jacobs, T. Wetter, P. Creissard, N. Martinez, J. Weidenfeldl, H. J. Sturenburg, G. Damlacik, V. Gracia, J. C. Turpin, A. Pou-Serradell, J. P. Vincent, T. Gagoshidze, U. Ozkutlu, M. McLeod, K. Siegfried, I. Tchaoussoglou, J. Hildebrand, S. Kowalska, M. C. Picot, G. Galardin, L. Crevits, F. Andreetta, S. Larumbe-Lobalde, G. de la Sierra, J. C. Alvarez-Cermeno, R. J. Seitz, P. L. Oey, L. Ptacek, A. M. J. Paans, A. Wirrwar, A. Schmied, J. Uilchez, H. Tounsi, D. Hipola, V. Avoledo, Y. Hirata, P. Vermersch, T. M. Aisonobe, J. Valls-SoIè, H. Staunton, J. Dichgans, R. Karabudak, I. Dones, G. Porta, E. Janssens, Maria Martinez, J. M. Fernandez-Real, R. Villagra, Y. Yoshino, C. Kabus, K. Schimrigk, I. Girard-Buttaz, F. Piccoli, F. Aichner, P. Zuchegna, S. M. Al Deeb, F. Bono, N. Busquets, A. Jobert, Patrizia Ciscato, M. Martin, L. Polman, S. Darbra, V. Le Cam-Duchez, F. Baldissera, B. Baykan-Kurt, D. Guez, M. Bratoeva, H. Matsui, M. Mila, H. Perron, L. Bjorge, G. Husby, Steven T. DeKosky, D. R. Cornblath, J. M. Gabriel, J. J. Poza, Y. Wu, A. Toscano, R. P. Kleyweg, J. Kuhnen, S. O. Confort-Gouny, A. Barcelo, A. M. Conti, C. Fiol, C. Steichen-Wiehn, J. Rodes, M. Cavenaile, C. Vedeler, M. Drlicek, C. Argentino, M. L. Peris, A. Cervello, A. Z. GinaÏ, S. Yancheva, D. Passingham, S. Aoba, D. L. 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Garcia de Yebenes, N. K. Olsen, P. Hitzenberger, S. Einius, Aj Thompson, Ch. J. Vecht, T. Crepin-Leblond, Klaus L. Leenders, A. Di Muzio, L. Georgieva, René Spiegel, K. Sabey, D. Ménégalli, J. Meulstee, U. Liszka, P. Giral, C. Sunol, J. M. Espadaler, A. D. Crockar, K. Varli, G. Giraud, P. J. Hülser, A. Benazzouz, A. Reggio, M. Salvatore, K. Genc, M. Kushnir, S. Barbieri, J. Ph. Azulay, M. Gianelli, N. Bathien, A. AlMemar, F. Hentati, I. Ragueneau, F. Chiarotti, R. C. F. Smits, A. K. Asbury, F. Lacruz, B. Muller, Alan J. Thompson, Gordon Smith, K. Schmidt, C. Daems Monpeun, Juergen Weber, A. Arboix, G. R. Fink, A. M. Cobo, M. Ait Kaci Ahmed, E. Gencheva, Israel-Biet, G. Schlaug, P. De Jonghe, Philip Scheltens, K. Toyka, P. Gonzalez-Porque, A. Cila, J. M. Fernandez, P. Augustin, J. Siclia, S. Medaglini, D. E. Ziogas, A. Feve, L. Kater, G. J. E. Rinkel, D. Leppert, Rüdiger J. Seitz, S. Ried, C. Turc-Carel, G. Smeyers, F. Godinho, M. Czygan, M. Rijntjes, E. Aversa, M. Frigo, Leif Østergaard, J. L. Munoz Blanco, A. Cruz-Matinez, J. De Reuck, C. Theillet, T. Barroso, V. Oikonen, Florence Lebert, M. Kilinc, C. Cordon-Cardon, G. Stoll, E. Thiery, F. Pulcinelli, J. Solski, M. Schmiegelow, L. J. Polman, P. Fernandez-Calle, C. Wikkelso, M. Ben Hamida, M. Laska, E. Kott, W. Sulkowski, C. Lucas, N. M. Bornstein, D. Schmitz, M. W. Lammers, A. de Louw, R. J. S. Wise, P. A. van Darn, C. Antozzi, P. Villanueva, P. H. E. Hilkens, C. Constantin, W. Ricart, A. Wolf, M. Gamba, P. Maguire, Alessandro Padovani, B. M. Patten, Marie Sarazin, H. Ackermann, L. Durelli, S. Timsit, Sebastian Jander, B. W. Scheithauer, G. Demir, J. P. Neau, P. Barbanti, A. Brand, N. AraÇ, V. Fischer-Gagnepain, R. Marchioli, G. Serratrice, C. Maugard-Louboutin, G. T. Spencer, D. Lücke, G. Mainardi, K. Harmant Van Rijckevorsel, G. B. Creel, R. Manzanares, Francesco Fortunato, A. May, J. Workman, K. Johkura, E. Fernandez, Carlo Colosimo, L. Calliauw, L. Bet, Félix F. Cruz-Sánchez, M. Dhib, H. 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Brizioli, J. Calleja, L. Publio, M. Desi, R. Soffietti, P. Cortinovis-Tourniaire, E. F. Gonano, G. Cavaletti, S. Uselli, K. Westerlind, H. Betuel, C. O. Dhiver, H. Guggenheim, M. Hamon, R. Fazio, P. Lehikoinen, A. Esser, B. Sadzot, G. Fink, Angelo Antonini, D. Bendahan, V. Di Carlo, G. Galardi, A. F. Boller, M. Aksenova, Del Fiore, V. de la Sayette, H. Chabriat, A. Nicoletti, A. Dilouya, M. L. Harpin, E. Rouillet, J. Stam, A. Wolters, M. R. Delgado, Eduardo Tolosa, G. Said, A. J. Lees, L. Rinaldi, A. Schulze-Bonhage, MA Ron, C. Lefebvre, E. W. Radü, R. Alvarez, M. L. Bots, P. Reganati, S. Palazzi, A. Poggi, N. J. Scolding, V. Sazdovitch, T. Moreau, E. Maes, M. A. Estelies, P. Petkova, Jose-Felix Marti-Masso, G De La Meilleure, N. Mullatti, M. Rodegher, N. C. Notermans, T. A. T. Warner, S. Aktan, J. P. Louboutin, L. Volpe, C. Scheidt, W. Aust, C. M. Wiles, U. Schneider, S. K. Braekken, W. R. Willems, K. Usuku, Peter M. Rothwell, C. Talamon, M. L. Sacchetti, A. Codina, M. H. Marion, A. Santoro, J. Roda, A. Bordoni, D. J. Taylor, S. Ertas, H. H. Emmen, J. Vichez, V. BesanÇon, R. E. Passingham, M. L. Malosio, A. Vérier, M. Bamberg, A. W. Hansen, E. Mostacero, G. Gaudriault, Marie Vidailhet, B. Birebent, K. Strijckmans, F. Giannini, T. Kammer, I. Araujo, J. Nowicki, E. Nikolov, A. Hutzelmann, R. Gherardi, J. Verroust, L. Austoni, A. Scheller, A. Vazquez, S. Matheron, H. Holthausen, J. M. Gerard, M. Bataillard, S. Dethy, V. H. Patterson, V. Ivanez, N. P. Hirsch, F. Ozer, M. Sutter, C. Jacomet, M. Mora, Bruno Colombo, A. Sarropoulos, T. H. Papapetropoulos, M. Schwarz, D. S. Dinner, N. Acarin, B. Iandolo, J. O. Riis, P. R. J. Barnes, F. Taroni, J. Kazenwadel, L. Torre, A. Lugaresi, I. L. Henriques, S. Pauli, S. Alfonso, Pedro Quesada, A. S. T. Planting, J. M. Castilla, Thomas Gasser, M. Van der Linden, A. Alfaro, E. Nobile-Orazio, G. Popova, W. Vaalburg, F. G. A. van der Mech, L. Williams, F. Medina, J. P. Vernant, J. Yaouanq, B. Storch-Hagenlocher, A. Potemkowski, R. Riva, M. H. Mahagne, M. Ozturk, Ve. Drory, N. Konic, C. Jungreis, A. Pou Serradell, J. L. Gauvrit, G. J. Chelune, S. Hermandez, T. Dingus, L. Hewer, Ch. Koch, M. N. Metz-Lutz, G. Parlato, M. Sinaki, Charles Pierrot-Deseilligny, H. C. Diener, J. Broeckx, J. Weill-Fulazza, M. L. Villar, M. Rizzo, O. Ganslandt, C. Duran, N. A. Fletcher, G. Di Giovacchino, Susan T. Iannaccone, C. Kolig, N. Fabre, H. A. Crockard, Rita Bella, M. Tazir, E. Papagiannuli, K. Overgaard, Emma Ciafaloni, I. Lorenzetti, F. Viader, P. A. H. Millac, I. Montiel, L. H. Visser, M. Palomar, P. L. Murgia, H. Pedersen, Rafael Blesa, S. Seddigh, W. O. Renier, I. Lemahieu, H. M. L. Jansen, L. Rosin, J. Galofre, K. Mattos, M. Pondal, G. M. Hadjigeorgiou, D. Francis, L. Cantin, D. Stegeman, M. Rango, A. B. M. F. Karim, S. Schraff, B. Castellotti, I. Iriarte, E. Laborde, T. J. Tjan, R. Mutani, D. Toni, B. Bergaasco, J. G. Young, C. Klotzsch, A. Zincone, X. Ducrocq, M. Uchuya, O. J. Kolar, A. Quattrone, T. 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Butterfield, P. P. Costa, F. deRino, F. Bamonti, J. M. Cesar, C. H. Lahoz, I. Mosely, M. Starck, M. H. Lemaitre, K. M. Stephan, S. Tex, R. Bokonjic, I. Mollee, L. Pastena, M. Gutierrez, F. Boiler, M. C. Martinez-Para, M. Velicogna, O. Obuz, A. Grinspan, M. Guarino, L. M. Cartier, E. Ruiz, D. Gambi, S. Messina, M. Villa, Michael G. Hanna, J. Valk, Leone Pascual, M. Clanet, Z. Argov, B. Ryniewicz, E. Magni, B. Berlanga, K. S. Wong, C. Gellera, C. Prevost, F. Gonzalez-Huix, R. Petraroli, J. E. G. Benedikz, I. Kojder, C. Bommelaer, L. Perusse, M. R. Bangioanni, Guy M. McKhann, A. Molina, C. Fresquet, E. Sindern, Florence Pasquier, M. J. Rosas, M. Altieri, O. Simoncini, M. Koutroumanidis, C. A. F. Tulleken, M. Dary-Auriol, S. Oueslati, H. Kruyer, I. Nishisho, C. R. Horning, A. Vital, G. V. Czettritz, J. Ph. Neau, B. Mihout, A. Ameri, M. Francis, S. Quasthoff, D. Taussig, S. Blunt, P. Valentin, C. Y. Gao, O. Heinzlef, H. d'Allens, C. Coudero, M. Erfas, G. Borghero, P. J. Modrego Pardo, M. C. Patrosso, N. L. Gershfeld, P. A. J. M. Boon, O. Sabouraud, M. Lara, J. Svennevig, G. L. Lenzi, A. Barrio, H. Villaroya, JosÇ M. Manubens, O. Boespflug-Tanguy, M. Carreras, D. A. Costiga, J. P. Breux, S. Lynn, C. Oliveras Ley, A. G. Herbaut, J. Nos, C. Tornali, Y. A. Hekster, J. L. Chopard, J. M. Manubens, P. Chemouilli, A. Jovicic, F. Dworzak, S. Smirne, S. E. Soudain, B. Gallano, D. Lubach, G. Masullo, G. Izquierdo, A. Pascual Leone Pascual, A. Sessa, V. Freitas, O. Crambes, L. Ouss, G. W. Van Dijk, P. Marchettini, P. Confalonieri, M. Donaghy, A. Munnich, M. Corbo, and M. E. L. van der Burg
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Neurology ,business.industry ,Media studies ,Library science ,Medicine ,Neurology (clinical) ,business - Published
- 1994
- Full Text
- View/download PDF
10. Aspects of pharmacotherapy in epilepsy
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H. Meinardi
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Epilepsy ,Psychotherapist ,business.industry ,Mechanism (biology) ,medicine.disease ,Clinical Practice ,Basic knowledge ,Pharmacotherapy ,Neurology ,Animals ,Humans ,Medicine ,Anticonvulsants ,Neurology (clinical) ,business ,Neuroscience - Abstract
Notwithstanding important advances in the treatment of epilepsy basic knowledge about the epilepsies and about the mechanism of action of antiepileptic drugs is still fragmentary. This statement is illustrated with examples from the laboratory and clinical practice. In particular it is emphasized that not only is little known about the mechanism of side-effects but also little work appears to be in progress to change that situation.
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- 1992
- Full Text
- View/download PDF
11. Preliminary Assessment of the Efficacy of Org 6370 in Photosensitive Epileptic Patients: Paradoxical Enhancement of Photosensitivity and Provocation of Myoclonic Seizures
- Author
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H. Meinardi, D. G. A. Kateleijn-Nolst Trenite, C. M. Groenhout, and T. W. Van Emde Boas
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Adult ,Bridged-Ring Compounds ,Male ,Gynecology ,Acute effects ,medicine.medical_specialty ,Dose-Response Relationship, Drug ,Photic epilepsy ,business.industry ,Administration, Oral ,Electroencephalography ,Surgery ,Bridged Bicyclo Compounds ,Oral ingestion ,Neurology ,Photosensitivity ,Myoclonic Seizures ,medicine ,Humans ,Anticonvulsants ,Epilepsy, Generalized ,Female ,Neurology (clinical) ,business ,Photic Stimulation - Abstract
Summary: Photosensitivity has proved to be a useful model to study the acute effects of experimental antiepileptic drugs (AEDs). The photosensitivity range is usually diminished or even abolished after administration of a known or experimental AED. An increase in photosensitivity, an unexpected reaction, was found in four photosensitive epileptic patients after oral ingestion of 500, 100, or 50 mg of Org 6370. Moreover, the three patients receiving doses of 100 and 500 mg reported nausea, dizziness, restlessness, and an increase in spontaneous epileptic seizures (myoclonus and in one patient a generalized tonic-clonic convulsion). The side effects coincided with peak Org 6370 serum levels. Our findings indicate that in the photosensitivity model experimental drugs with proven anticonvulsant properties in animals may increase rather than decrease the degree of patient photosensitivity. Photosensitive patients may represent a special subgroup of epileptic patients and therefore need to be classified as such. RESUME La photosensibilite est un modele d'etude des effets aigus de medicaments antiepileptiques experimentaux. L'etendue de la photosensibilite est habituellement diminuee et merne abolie apres administration d'un medicament epileptique connu ou experimental. Une augmentation inattendue de la photosensibilite a ete constatee chez 4 patients epileptiques photosensibles apres ingestion de 500, 100 ou 50 mg d'ORG 6370. De plus, les trois patients traites par des doses de 100 et 500 mg ont signale des nausees, des sensations vertigineuses, une agitation et une augmentation des crises epileptiques spontanees (myoclonies et chez un patient une crise generalisee tonico-clonique). Ces effets secondaires ont coincide avec les taux seriques les plus eleves d'0RG 6370. Ces constatations indiquent que dans le modele de la photosensibilite, les medicaments experimentaux avec activite anticonvulsivante prouvee chez l'animal, peuvent augmenter la 6 des patients. Les patients avec photosensibilitie peuvent representer un sous-groupe special parmi les patients epileptiques, et devraient donc etre classes comme tels. RESUMEN La fotosensibilidad es un modelo para estudiar los efectos agudos de las rnedicaciones antiepilepticas experimentales. El rango de fotosensibilidad esta habitualmente reducido incluso abolido despues de la adrninistracion de medicaciones antiepilepticas experimentales o conocidas. Se ha encontrado un incremento de la fotosensibilidad, como reaccion inesperada, en 4 epilepticos fotosensibles despues de la ingestion oral de 500, 100 o 50 mg de Prg 6370. Ademas los 3 pacientes que recibian de 100 a 500 mg notaron nausea, mareo, inquietud y un incremento de los ataques epilepticos espontaneos (rnioclonias y, en un enfermo, convulsiones generalizadas tonico-clonicas). Los efectos colaterales coincidieron con los niveles sericos mas altos del Org 6370. Nuestros hallazgos indican que en el modelo de fotosensibilidad para estudio experimental de drogas con propiedades anticonvulsivas en animales puede incrementar mas que reducir el grado de fotosensibilidad en pacientes que la poseen. Los paciente fotosensibles representan un subgrupo especial de epilepticos y por lo tanto deben clasificarse como tales. ZUSAMMENFASSUNG Die Fotosensibilitat gilt als ein Modell, urn die Sofortwirkung von experimentellen Antiepileptika (AED) zu untersuchen. Die FS wird gewohnlich verrnindert oder unterbrochen nach Gabe von bekannten AED. Eine Steigerung der FS, als unerwartete Reaktion wurde bei 4 Patienten nach oraler Gabe von 500, 100 und 50 mg Org 6370 beobachtet. Daruberhlnaus berichteten die Patienten mit Dosen von 100–500 mg uber ubelkeit, Benornmenheit, Unruhe und verrnehrte epiletische Anfalle (myoklonische und bei einem Patienten generalisierte tonisch-klonische Anfalle). Die Nebenwirkungen fielen rnit Serumspiegel-Spitzen von Org 6370 zusammen. Unsere Befunde sprechen dafur, daβ im FS-Modell rnit Prufmedikamenten mit erwiesenen antikonvulsiven Eigenschaften irn Tierversuch die FS bei Patieten verstarkt statt vermindert werden kann. FS-Patienten stellen moglicherweise eine besondere Untergruppe epileptischer Patienten dar und sollten deshalb als solche klassifiziert werden.
- Published
- 1992
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12. CLASSIFICATION | History of the Classifications of the Epilepsies
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H. Schneble and H. Meinardi
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- 2009
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13. Fetal Rest-Activity Cycles and Chronic Exposure to Antiepileptic Drugs
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H.C. Schoemaker, H. P. Geijn, H. Meinardi, M. Alphen, and J.M. Swartjes
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Adult ,medicine.medical_specialty ,Eye Movements ,Physiology ,Gestational Age ,Ultrasonography, Prenatal ,Embryonic and Fetal Development ,Fetal Heart ,Heart Rate ,Pregnancy ,Internal medicine ,medicine ,Birth Weight ,Humans ,Fetal Monitoring ,Fetal Movement ,Maternal-Fetal Exchange ,Fetus ,Epilepsy ,business.industry ,Infant, Newborn ,Body movement ,medicine.disease ,Trunk ,Teratology ,Pregnancy Complications ,Endocrinology ,Neurology ,embryonic structures ,Fetal movement ,Toxicity ,Apgar Score ,Gestation ,Anticonvulsants ,Female ,Neurology (clinical) ,business ,Maternal Age - Abstract
Summary: Rest-activity patterns were studied in fetuses exposed to antiepileptic drugs (AEDs) and in control fetuses at three intervals during pregnancy: 20, 32, and 38 weeks. At 20 weeks, periods of rest and activity were distinguished on the basis of fetal motility. Trunk, head, and arm movements were totaled. Periods of absence of movements for >3 min were found in 20 of 31 recordings from AED-exposed fetuses compared with 11 of 20 recordings from controls (p > 0.05). The duration of these periods of inactivity did not differ significantly between the two groups. At 32 and 38 weeks, information on fetal motility and fetal heart rate (FHR) were combined to recognize rest-activity patterns according to the fetal behavioral state concept. At 32 weeks, three true fetal behavioral states were found for the study group, while there were none in the control group. Coincidence 1F through 4F occurred significantly less frequently at 32 weeks than at 38 weeks, regardless of whether fetuses were AED-exposed or not: 59% vs. 82% for the study group and 59% vs. 80% for the controls. At 38 weeks, true fetal behavioral states appeared in 20 of 34 fetuses exposed to AEDs and in 17 of 35 controls (p > 0.05). The sequence in which parameters changed within state transitions was found to follow the same preferred pattern in both groups. For transitions from behavioral state 1F (quiet sleep) into 2F (active sleep) the FHR pattern changed significantly earlier than fetal body or eye movements, while for the reverse transitions the FHR pattern changed significantly later (p < 0.05). No clearly preferred sequence of the other two state parameters was found. We concluded that chronic intrauterine exposure to AEDs does not affect fetal rest-activity patterns.
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- 1991
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14. Lateralized Effects of Subclinical Epileptiform EEG Discharges on Scholastic Performance in Children
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B.M. Siebelink, D.G.A. Kasteleijn-Nolst Trenité, J. W. Strien, H. Meinardi, and S. G. C. Berends
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Male ,medicine.medical_specialty ,Elementary cognitive task ,Adolescent ,Audiology ,Electroencephalography ,Functional Laterality ,Lateralization of brain function ,Epilepsy ,Cognition ,medicine ,Humans ,Child ,Subclinical infection ,Intelligence Tests ,Intelligence quotient ,medicine.diagnostic_test ,Brain ,Achievement ,medicine.disease ,Reading ,Neurology ,Laterality ,Female ,Neurology (clinical) ,Mathematics ,Psychomotor Performance - Abstract
The interaction between lateralization of subclinical epileptiform discharges and cognitive tasks was investigated in 21 children (12 girls and 9 boys, mean age 10.6 years). Seventeen had a diagnosis of epilepsy (partial or secondarily generalized). Testing was by reading, arithmetic, and intelligence subtests during continuous telemetric EEG and video monitoring. Children with left-sided discharges had significantly lower reading performance than children with right-sided discharges. During reading, epileptiform discharges occurred relatively less frequently and with a shorter total duration over the left hemisphere than the right. This supports the view that cognitive tasks suppress epileptiform discharges when they activate a region of the brain within the epileptogenic zone. Discharges from other epileptogenic zones not directly activated by the tasks are increased, however.
- Published
- 1990
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15. Epilepsy and Sports
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H. Meinardi, O. G. M. Mulder, F. J. G. Backx, and R. van Linschoten
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medicine.medical_specialty ,Sports medicine ,medicine.medical_treatment ,Physical fitness ,Poison control ,Physical Therapy, Sports Therapy and Rehabilitation ,Suicide prevention ,Epilepsy ,Risk Factors ,Injury prevention ,Prevalence ,Humans ,Medicine ,Orthopedics and Sports Medicine ,Medical history ,Psychiatry ,Exercise ,Rehabilitation ,business.industry ,Incidence ,Prognosis ,medicine.disease ,Physical therapy ,business ,human activities ,Sports - Abstract
Millions of healthy people participate in sport on a regular basis. Moreover, in the last decade patients with chronic disorders have been encouraged to take part in sporting activities as a part of their rehabilitation. Can epileptic patients freely participate in sport or whether they are restricted to a certain extent by their disorder? An important factor is freedom from seizures. If seizures have been controlled for over 2 years the risk of relapse is the same as the risk of a first seizure. The risk of patients drowning or falling, or their epilepsy worsening because they are engaged in sport is thought to be low. Clinical data suggest that the incidence of seizures during sports and exercise is reduced. In the cooling down period, however, seizures tend to occur more frequently. Physicians should encourage epileptic patients to participate in sporting activities to enhance their physical fitness, self-esteem, and social integration. Before giving advice about the most suitable type of sport, the physician should known the patient's medical history, have a good insight into the different types of sport and be able to judge the role and function of sport to the particular patient. With certain precautions virtually all sports are suitable for most epileptic patients and should therefore be encouraged. However, a small minority of hospitalised patients with severe epilepsy need the supervision of qualified trainers, coaches and volunteers.
- Published
- 1990
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16. Phannacokinetic-pharmacodynamic modelling of the anticonvulsant effect of oxazepam in individual rats
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M. W. E. Langemeijer, Meindert Danhof, R A Voskuyl, Ineke Postel-Westra, H. Meinardi, Douwe D. Breimer, and J. Dingemanse
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Pharmacology ,Volume of distribution ,Dose-Response Relationship, Drug ,Seizure threshold ,Oxazepam ,Chemistry ,medicine.medical_treatment ,Rats, Inbred Strains ,Models, Biological ,Rats ,Dose–response relationship ,Cmin ,Anticonvulsant ,Pharmacokinetics ,Pharmacodynamics ,medicine ,Animals ,Anticonvulsants ,Female ,Research Article ,medicine.drug - Abstract
1. The purpose of this investigation was to examine in vivo drug-concentration anticonvulsant effect relationships of oxazepam in individual rats following administration of a single dose. 2. Whole blood concentration vs time profiles of oxazepam were determined following administration of doses of 4, 8 and 12 mg kg-1. The pharmacokinetics could be described by an open 2-compartment pharmacokinetic model. Following 12 mg kg-1 the values (mean +/- s.e., n = 11) of clearance and volume of distribution were 28 +/- 2 ml min-1 kg-1 and 2.6 +/- 0.31 kg-1, respectively, and were not significantly different from the values obtained at the other doses. 3. The anticonvulsant effect was quantitated by a new technique which allows repetitive determination of the convulsive threshold by direct cortical stimulation within one rat. Significant dose-dependent elevations of the seizure threshold were observed. 4. By pharmacokinetic-pharmacodynamic modelling, a log-linear relationship was found between concentration and anticonvulsant effect. Following 12 mg kg-1 the values (mean +/- s.e., n = 11) of the pharmacodynamic parameters slope and minimal effective concentration (Cmin) were 243 +/- 27 microA and 0.11 +/- 0.02 mg l-1, respectively and not significantly different from the values obtained at the other doses. 5. In a repeatability study the pharmacodynamic parameters were determined twice on two different occasions with an interval of two weeks in the same group of 11 rats. The inter-animal variability in the pharmacodynamic parameter slope was 46%, whereas the intra-animal variability was 24 +/- 18%. The value of the minimal effective concentration was in each animal and on each occasion close to zero within the relatively narrow range of 0.01-0.30mgI. 6. The results of this study showed that it is possible to determine in vivo concentration-anticonvulsant effect relationships of oxazepam under non-steady-state conditions in individual rats. The anti-convulsant effect of oxazepam appeared to be a rapidly reversible direct effect and acute tolerance did not develop within the time frame of the experiments.
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- 1990
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17. Development of diagnostic reference frames for seizures. Part 2: are seizure descriptions discriminative?
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Jan L. Talmon, Arie Hasman, W. O. Renier, H. Meinardi, P. P. M. Ahles, J. F. van Ast, and Medical Informatics
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Matching (statistics) ,Epileptologist ,medicine.medical_specialty ,Medical Records Systems, Computerized ,Health Informatics ,Audiology ,Correlation ,Diagnosis, Differential ,Epilepsy ,Discriminative model ,Seizures ,medicine ,Humans ,Decision Making, Computer-Assisted ,Observer Variation ,business.industry ,Seizure types ,Reproducibility of Results ,Pattern recognition ,Electroencephalography ,medicine.disease ,Neurology ,Artificial intelligence ,business ,Psychology ,Knowledge elicitation ,Reference frame - Abstract
Objective: To determine whether the seizure descriptions given by a group of neurologists/epileptologists are discriminative. Method: We constructed templates for various seizure types describing how often symptoms were selected by the participants. We defined a matching score to indicate the match between such a template and the symptoms selected by each neurologist/epileptologist individually and computed the scores for each of the sets of selected symptoms with all templates. Correlation coefficients were calculated between the templates. Results: Data were collected from 24 participants. The matching scores and the correlation coefficients both show that participants provide discriminative descriptions of the seizure types. Descriptions of aggregated seizure types, such as primary generalized seizures, are less discriminatory than the descriptions of more specific seizure types. Conclusion: We concluded that the participants in our study selected symptoms that result in discriminative descriptions of the seizure types. This indicates that knowledge elicitation by using the opinions of a group of clinical experts is possible. The study also indicates that the design of the study could be ameliorated in several ways. These findings will be taken into account when designing the final study.
- Published
- 2003
18. Validating a decision support system for anti-epileptic drug treatment. Part II: adjusting anti-epileptic drug treatment
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R, Smeets, J, Talmon, H, Meinardi, and A, Hasman
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Observer Variation ,Epilepsy ,Neurology ,Software Validation ,Decision Making ,Humans ,Anticonvulsants ,Expert Systems ,Drug Monitoring ,Decision Support Systems, Clinical ,Medical Records ,Follow-Up Studies - Abstract
A model of expertise for monitoring antiepileptic drug treatment was implemented in a decision support system. We validated the advice of the system regarding treatment decisions at first follow-up with 265 paper cases based on patient records. The reference for comparison is based on the opinions of neurologists. We found considerable variation among the decisions of five neurologists. It could be shown that the system agreed with (groups of) neurologists at least as often as individual neurologists did. The correctness of the system was consistently higher than that of each of the neurologists, when the majority decision of the remaining neurologists constituted the standard.
- Published
- 2000
19. Validating a decision support system for anti-epileptic drug treatment. Part I: initiating anti-epileptic drug treatment
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R, Smeets, J, Talmon, H, Meinardi, and A, Hasman
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Adult ,Male ,Epilepsy ,Adolescent ,Delphi Technique ,Software Validation ,Expert Systems ,Middle Aged ,Decision Support Systems, Clinical ,Drug Prescriptions ,Neurology ,Practice Guidelines as Topic ,Humans ,Anticonvulsants ,Epilepsy, Generalized ,Female ,Epilepsies, Partial ,Aged - Abstract
In this contribution the validation of a prototype decision support system that implements a model of expertise for initiating anti-epileptic drug treatment is described. Since domain experts were of the opinion that prescribing was a rather straightforward process we used only one expert neurologist for knowledge elicitation. To determine the correctness of the system we intended to compare the contents of the system's prescriptions with the majority decision of three neurologists. Because of a large variation in prescribing a majority decision could not be obtained in many cases. Even a Delphi procedure did not yield a majority decision in a large number of cases. Therefore a consensus meeting was organised to discuss cases where discrepancies remained. In the process the participating neurologists formulated prescription guidelines. These guidelines were used as a reference to determine the correctness of the prescriptions of both the system and of the neurologists. The acceptability of all prescriptions for each case was rated by the two neurologists who did not write a prescription for that case. From both comparisons it could be concluded that the system was at least as good in prescribing as individual neurologists.
- Published
- 2000
20. Effects of polytherapy compared with monotherapy in antiepileptic drugs: an animal study
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G, Roks, C L, Deckers, H, Meinardi, R, Dirksen, J, van Egmond, and C M, van Rijn
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Male ,Behavior, Animal ,Dose-Response Relationship, Drug ,Hand Strength ,Valproic Acid ,Rats ,Animals ,Ethosuximide ,Anticonvulsants ,Ataxia ,Drug Interactions ,Drug Therapy, Combination ,Nervous System Diseases ,Rats, Wistar - Abstract
Although monotherapy in epilepsy treatment is frequently advocated, this is not based on studies with equal drug loads. This study was performed to investigate the experimental background of polytherapy with standardized drug loads. Dose-dependent effects on grip strength, accelerod performance, and spontaneous behavior of rats was used to study the effect of combining valproate and ethosuximide. The potency of the drugs (combination) was obtained by fitting the sigmoid Emax equation to the data. Drug interaction was assessed using the isobologram method and quantified by comparing equivalent drug loads with their 95% confidence intervals. We found that the effects of valproate and ethosuximide combine in a simple additive way in the grip strength experiment as well as in the accelerod experiment. In the behavioral studies, however, a higher drug load of the combination was needed to obtain the same amount of sedation, signifying infra-additivity. Infra-additivity of sedative effects is an important finding because this is by far the most frequent side effect mentioned in human studies. However, assessment of the therapeutic effect of the combination will have to be completed before a preference for mono- or polytherapy, based on the balance of adverse effects and efficacy, can be expressed.
- Published
- 1999
21. Agreement and correctness in adjusting antiepileptic drug treatment: a need for rational drug treatment?
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R. P. A. M. Smeets, H. Meinardi, Jan L. Talmon, and Arie Hasman
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medicine.medical_specialty ,Decision support system ,Correctness ,Attitude of Health Personnel ,Decision Making ,Antiepileptic drug ,Pathofysiologie van Hersenen en Gedrag ,Pathophysiology of Brain and Behaviour ,Drug Administration Schedule ,Medical Records ,Majority decision ,Drug treatment ,mental disorders ,Ambulatory Care ,medicine ,Humans ,Medical prescription ,Psychiatry ,Netherlands ,Observer Variation ,Medical Audit ,Epilepsy ,business.industry ,Decision Support Systems, Clinical ,nervous system diseases ,Test (assessment) ,Neurology ,Family medicine ,Interobserver Variation ,Anticonvulsants ,Neurology (clinical) ,business - Abstract
Summary: Purpose: To study interobserver variation in treatment decisions in a first follow-up contact after initiation of antiepileptic drug (AED) treatment. The results should aid us in the assessment of whether decision support can be of value in this situation. Methods: Data from patient records were used to construct 270 different test cases containing information about the course of the disease after initiation of drug treatment. The cases were presented to five neurologists from different general hospitals who previously agreed about the diagnosis and the initial treatment for these cases. They were asked to write a prescription for each test case. Results: All five neurologists agreed on a treatment decision in 21.9% of the 265 cases available for analysis. Each neurologist made a decision different from the decisions taken by all other neurologists in 14.0–19.6% of the cases. Kappa values for agreement among individual neurologists as well as for agreement between an individual and the group of his peers were low. In 82.6% of the cases, a majority of the neurologists agreed on a treatment decision. Comparing the decisions of individual neurologists with the majority decision reference (219 cases) showed a significant difference in correctness (range, 67.1–82.6%) among the neurologists. Conclusions: The fact that a majority decision could be reached in a considerable number of cases, as well as the variability in adjustment of an initiated drug treatment, leads us to the conclusion that decision support can contribute to a rational adjustment of drug treatment.
- Published
- 1999
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22. Maternal use of antiepileptic drugs and the risk of major congenital malformations: a joint European prospective study of human teratogenesis associated with maternal epilepsy
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Dick Lindhout, V K Hiilesmaa, S Koch, H. Meinardi, C M van Duijn, A. Hofman, A H Bardy, E. B. Samren, H. Klepel, Eija Gaily, G B Mannagetta, D. Janz, D. E. Grobbee, Marja-Liisa Granström, A W Deichl, Epidemiology, and Clinical Genetics
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Male ,Pediatrics ,Pathophysiology of Brain and Behaviour ,Cohort Studies ,0302 clinical medicine ,Mental Retardation ,Pregnancy ,Risk Factors ,Multicenter Studies as Topic ,Prospective Studies ,030212 general & internal medicine ,Prospective cohort study ,Maternal-Fetal Exchange ,GeneralLiterature_REFERENCE(e.g.,dictionaries,encyclopedias,glossaries) ,Neurons ,education.field_of_study ,Abnormalities, Drug-Induced ,Brain ,Middle Aged ,3. Good health ,Neurology ,Anesthesia ,Gestation ,Anticonvulsants ,Drug Therapy, Combination ,Female ,medicine.drug ,Adult ,medicine.medical_specialty ,Adolescent ,Offspring ,Population ,Pathofysiologie van Hersenen en Gedrag ,03 medical and health sciences ,medicine ,Humans ,education ,Nervous System Abnormalities (Non MeSH) ,Epilepsy ,Dose-Response Relationship, Drug ,business.industry ,Infant, Newborn ,Carbamazepine ,medicine.disease ,Teratology ,Pregnancy Complications ,Relative risk ,Neurology (clinical) ,Nerve Net ,business ,030217 neurology & neurosurgery - Abstract
Summary: Purpose: To quantify the risks of intrauterine antiepileptic drug (AED) exposure in monotherapy and poly-therapy. Methods: Data from five prospective European studies totaling 1,379 children were pooled and reanalyzed. Data were available for 1,221 children exposed to AED during pregnancy and for 158 children of unexposed control pregnancies. Results: Overall, when comparing a subgroup of 192 children exposed to AED with 158 children of matched nonepileptic controls, there was an increased risk of major congenital malformations (MCA) in children exposed to AED during gestation [relative risk (RR) 2.3; 95% confidence interval (CI): 1.2–4.7]. A significant increase in risk was found for children exposed to valproate (VPA) (RR 4.9; 95% CI: 1.6–15.0) or carbamazepine (CBZ) (RR 4.9; 95% CI: 1.3–18.0) in monotherapy. When comparing different AED regimens during all 1,221 pregnancies, risks of MCA were significantly increased for the combination of phenobarbital (PB) and ethosuximide (RR 9.8; 95% CI: 1.4–67.3) and the combination of phenytoin, PB, CBZ, and VPA (RR 11.0; 95% CI: 2.1–57.6). Offspring of mothers using > 1,000 mg VPNday were at a significantly increased risk of MCA, especially neural tube defects, compared to offspring exposed ≥600 mg VPNday (RR 6.8; 95% CI: 1.4–32.7). No difference in risk of MCA was found between the offspring exposed to 601–1,000 mg/day and ≥600 mg/day. Conclusions: This reanalysis shows that VPA is consistently associated with an increased risk of MCA in babies born to mothers with epilepsy. Significant associations were also observed with CBZ. Larger prospective population-based studies are needed to evaluate the risks of many other less frequently prescribed treatment regimens, including newly marketed AEDs.
- Published
- 1997
23. Non-convulsive status epilepticus : causes, treatment, and outcome in 65 patients
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F.B.J. Scholtes, H. Meinardi, and Willy O. Renier
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Adult ,Male ,medicine.medical_specialty ,Pediatrics ,animal structures ,Adolescent ,Complex partial status epilepticus ,Pathofysiologie van Hersenen en Gedrag ,Status epilepticus ,Pathophysiology of Brain and Behaviour ,Injections, Intramuscular ,Epilepsy ,Epilepsy, Complex Partial ,Level of consciousness ,Mental Retardation ,Epidemiology ,medicine ,Humans ,GeneralLiterature_REFERENCE(e.g.,dictionaries,encyclopedias,glossaries) ,Retrospective Studies ,Nervous System Abnormalities (Non MeSH) ,Neurons ,Diazepam ,business.industry ,Incidence (epidemiology) ,Brain ,Electroencephalography ,Retrospective cohort study ,Middle Aged ,medicine.disease ,Surgery ,Psychiatry and Mental health ,Treatment Outcome ,Epilepsy, Absence ,Etiology ,Anticonvulsants ,Female ,Neurology (clinical) ,medicine.symptom ,Nerve Net ,business ,Research Article - Abstract
The incidence of non-convulsive status epilepticus (NCSE) in The Netherlands is not known. Files of admissions in the years 1980-7 were studied from 40 adult patients (older than 15 years) with complex partial status epilepticus (CPSE) and 25 with absence status epilepticus (ASE). The clinical presentation sometimes made distinction between CPSE and ASE possible. Focal clinical signs were more frequent in CPSE; a fluctuating level of consciousness was more often present in ASE. All patients, but one, with ASE and most patients with CPSE (28) were known to have had previous epilepsy. Outcome in ASE was good in all. Outcome in CPSE depended on the underlying cause and quality of treatment. In three patients inadequate treatment probably contributed to morbidity.
- Published
- 1996
24. EPICADEC quo vadis?
- Author
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H, Meinardi
- Subjects
Epilepsy ,Humans ,Organizational Objectives ,Voluntary Health Agencies ,Developing Countries ,Christianity ,Netherlands - Published
- 1994
25. General description of projects supported by EPICADEC
- Author
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H, Meinardi
- Subjects
Epilepsy ,Indonesia ,Humans ,Nigeria ,Organizational Objectives ,Voluntary Health Agencies ,Liberia ,Developing Countries ,Kenya ,Tanzania ,Netherlands ,Sri Lanka - Published
- 1994
26. Seizure Frequency as Treatment Effect Parameter: General Considerations
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M. W. Lammers and H. Meinardi
- Subjects
medicine.medical_specialty ,Epilepsy ,Seizure frequency ,partial seizures ,Frequency of occurrence ,business.industry ,medicine ,Treatment effect ,Audiology ,medicine.disease ,business ,Lennox–Gastaut syndrome - Abstract
As epilepsy is a paroxysmal disorder it seems self-evident that the frequency of occurrence of paroxysms is a sensible index. However, as Feinstein admonishes in his teachings on clinimetrics, the first question to be asked is for what purpose do we intend to use the index.
- Published
- 1993
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27. On the Reporting of Adverse Drug Events
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M. W. Lammers and H. Meinardi
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Drug ,medicine.medical_specialty ,business.industry ,media_common.quotation_subject ,Dose dependence ,Vigabatrin ,Seizure suppression ,Drug treatment ,Adverse drug event ,Pharmacodynamics ,medicine ,Intensive care medicine ,business ,Adverse effect ,media_common ,medicine.drug - Abstract
In this paper only dose dependent adverse drug events will be discussed. Adverse drug events are by definition a problem in efficacy studies. In studies of anti-epileptic drugs an additional problem arises. As the desired effect of an anti-epileptic drug is the suppression of a paroxysmal and unpredictable event, titration to reach an optimal dose is not readily practicable using the desired effect parameter. It is commonly accepted to substitute the occurrence of adverse effects as endpoint minus one for the titration phase. Of course this poses a problem with respect to the reporting of the occurrence of side effects. Proper policy would be to disregard side-effects elicited during a titration phase. The possibility to monitor serumlevels did offer a way out of this problem by choosing a serumlevel below the "toxic range" as first end-point of titration. However, recent anti-epileptic drugs show little or no correlation between serumlevels and pharmacodynamic properties of these drugs. Examples are vigabatrin and milacemide. If adverse effects are only to be reported during steady state and in relation to seizure suppression the whimsical nature of adverse events may become a confounding factor. As was shown by the epileptologists from Milani adverse effects mayor may not disappear spontaneously. There are no systematic studies about the pathophysiology of this tolerance phenomenon. However, there are anecdotal reports of people withdrawn from anti-epileptic drug treatment who felt much improved even though they did not have any formal complaints about adverse effects prior to withdrawal. In drug-trial reports the methods section often contains little information about the procedures with respect to the evaluation of adverse drug events. For example in a recent paper by Reynolds et al. 2 on a study of vigabatrin it is stated that "Efficacy was assessed
- Published
- 1993
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28. Individualization of Antiepileptic Drug Therapy
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D. J. P. Wijsman, E. W. Wuis, Y. A. Hekster, T. B. Vree, and H. Meinardi
- Subjects
Drug ,Pediatrics ,medicine.medical_specialty ,education.field_of_study ,medicine.diagnostic_test ,business.industry ,media_common.quotation_subject ,Population ,Disease ,medicine.disease ,Epilepsy ,Regimen ,Pharmacokinetics ,Therapeutic drug monitoring ,medicine ,education ,Adverse effect ,business ,media_common - Abstract
The ultimate goal of anti-epileptic drug (AED) therapy is to enable the patient to live a normal life. The usual approach is to maximize seizure control and to minimize the risk of adverse effects [Pugh and Garnett 1991]. After careful consideration of the nature of the epilepsy, chronic AED treatment should be started. The initial choice of a particular drug depends upon the type of disorder and on individual patient characteristics. Since large variations in AED pharmacokinetics have been observed, it is not possible to start the drug of choice with individualized, patient-tailored regimen. Individualization takes patient characteristics and drug characteristics into consideration, and tries to integrate these issues to obtain the most rational dosage schedule for that patient. Before such a step can be made, and individualization is obtained, drug regimen should be based on data obtained from groups of patients that have been treated for the particular seizure disorder with that particular drug. For that reason, the initial dose regimen for any patient is based on population pharmacokinetic data. Population pharmacokinetics can be defined as the study of the variability in plasma drug concentrations between individuals when standard dosage regimens are administered [Aarons 1991]. These studies assess the influence of patient’s variabilities, such as age, gender, race, pregnancy, liver and kidney function, on drug kinetics. In addition, drug characteristics such as metabolism, stereoselectivity and activity, drug-drug and drug-food interactions and, the influence of co-medication [Eadie 1991] are considered. Another factor influencing pharmacokinetic properties of a drug, includes the disease state itself [Encinas et al 1992, Vree et al 1989, Yukawa et al 1992].
- Published
- 1993
- Full Text
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29. Epidemiology of epilepsy
- Author
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H, Meinardi
- Subjects
Employment ,Epilepsy ,Child, Preschool ,Prevalence ,Humans ,Infant ,Psychology ,Child ,Developing Countries ,Severity of Illness Index ,Netherlands - Published
- 1993
30. Fetal heart rate patterns and chronic exposure to antiepileptic drugs
- Author
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J.M. Swartjes, H. P. Geijn, H. Meinardi, and R. Mantel
- Subjects
Central Nervous System ,medicine.medical_specialty ,Gestational Age ,Epilepsy ,Electrocardiography ,Fetus ,Pregnancy ,Internal medicine ,Statistical significance ,Heart rate ,medicine ,Humans ,medicine.diagnostic_test ,business.industry ,Gestational age ,Heart Rate, Fetal ,medicine.disease ,Pregnancy Complications ,Fetal heart rate ,Neurology ,embryonic structures ,Cardiology ,Anticonvulsants ,Female ,Neurology (clinical) ,business - Abstract
Fetal heart rate (FHR) characteristics of fetuses exposed and not exposed to antiepileptic drugs (AEDs) were studied. FHR is considered to reflect central nervous system (CNS) integrity. Three intervals during pregnancy were investigated: 20, 32, and 38 weeks. At 32 and 38 weeks, FHR was studied in relation to quiet (C1F) and active (C2F) sleep periods. For each tracing, a baseline was determined and accelerations and decelerations were identified. To assess FHR variability, the long-term irregularity, interval difference and absolute beat-to-beat indexes, and the bandwidth were calculated for 30-s intervals between accelerations and decelerations. No marked differences were noted between study and control groups concerning basal FHR and the occurrence of accelerations. For FHR derived from the fetal ECG, all indexes of FHR variability and the bandwidth were lower for the study group as compared with the control group, although the differences did not reach statistical significance. Our study shows that chronic prenatal exposure to AEDs does not seriously interfere with modulation of fetal heart rhythm by the CNS.
- Published
- 1992
31. Fetal motility and chronic exposure to antiepileptic drugs
- Author
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H.P. van Geijn, H. Meinardi, E.E. van Woerden, J.M. Swartjes, and R. Mantel
- Subjects
Adult ,medicine.medical_specialty ,Pregnancy Trimester, Third ,Physiology ,Motility ,Pregnancy ,Internal medicine ,Medicine ,Humans ,Fetal Movement ,Fetus ,Epilepsy ,business.industry ,Obstetrics and Gynecology ,medicine.disease ,Trunk ,General movements ,Pregnancy Complications ,Endocrinology ,Reproductive Medicine ,Pregnancy Trimester, Second ,embryonic structures ,Fetal movement ,Toxicity ,Gestation ,Anticonvulsants ,Female ,business - Abstract
The potential influence of antiepileptic drugs (AEDs) on fetal CNS function was studied with respect to motility patterns. Quantitative and qualitative aspects of spontaneous fetal activity were investigated for chronic AED-exposed fetuses and controls at three intervals during pregnancy: i.e. 20, 32 and 38 weeks. Movements were observed applying real-time ultrasound. Third trimester rest-activity cycles were determined according to the fetal behavioural state concept. Quantitative analysis revealed no marked differences in gross fetal motility between AED-exposed fetuses and controls. Both groups demonstrated the same developmental trend from midterm towards the third trimester. The number of trunk movements decreased, while their median duration increased. The incidence of fetal eye movements during C2F was lower for AED-exposed fetuses than for controls (significant for 38 weeks). In qualitative analysis, general movements of AED-exposed fetuses were more often labeled as suspect or abnormal than those of control fetuses (respectively, 8 out of 31 and 1 out of 20; P = 0.06). Future studies concerning chronic fetal AED-exposure and fetal CNS function should focus on qualitative rather than quantitative aspects of motility.
- Published
- 1992
32. Antiepileptic drugs and teratogenesis in two consecutive cohorts: changes in prescription policy paralleled by changes in pattern of malformations
- Author
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D, Lindhout, H, Meinardi, J W, Meijer, and H, Nau
- Subjects
Male ,Epilepsy ,Valproic Acid ,Infant, Newborn ,Abnormalities, Drug-Induced ,Infant ,Drug Prescriptions ,Cohort Studies ,Pregnancy Complications ,Carbamazepine ,Pregnancy ,Phenobarbital ,Phenytoin ,Humans ,Anticonvulsants ,Female - Abstract
We analyzed the influence of changes in the prescribing of antiepileptic drugs to pregnant women on frequency and pattern of malformations in their offspring by comparing two consecutive cohorts (1972 to 1979, cohort A; 1980 to 1985, cohort B). In cohort A, 15 (10%) of 151 exposed, live-born infants had one or more congenital anomalies, which consisted primarily of congenital heart defects, facial clefts, and syndromes of dysmorphia with developmental retardation, in association with polytherapy (carbamazepine plus phenobarbitone plus valproate, with or without phenytoin, or phenobarbitone plus phenytoin plus primidone). In cohort B, the prescribing of phenobarbitone, phenytoin, or primidone had dropped markedly, whereas monotherapy with valproate and carbamazepine had increased. Thirteen (7.6%) of 172 exposed, live-born infants had congenital anomalies. The most frequent anomalies were spinal defects (four) and glandular hypospadias (three), all in association with maternal therapy with valproate, carbamazepine, or both. The results underline the need for continuation of prospective studies to monitor the effect of change in prescribing policies and to evaluate the role of metabolic interactions between drugs prescribed in combination.
- Published
- 1992
33. Mental Deterioration at Epilepsy Onset: A Hypothesis
- Author
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H. Meinardi, A. P. Aldenkamp, and B. Nunes
- Subjects
Pediatrics ,medicine.medical_specialty ,Mental deterioration ,business.industry ,Head injury ,Poison control ,medicine.disease ,Occupational safety and health ,Surgery ,Epilepsy ,Injury prevention ,Intellectual disability ,Closed head injury ,medicine ,business - Abstract
In this study, we hypothesized a type of mental deterioration in epilepsy, characterized as a discontinued, cascading process, i. e. a sudden mental decline in a limited time interval, immediately after the onset of the seizures. The posttraumatic epilepsy model (PTE) may appear to be exceptionally useful in avoiding one of the major methodological obstacles for testing this hypotesis, i. e. the unvailability of test results obtained with the same battery of tests prior to and directly after the onset of the seizures. We propose a multicentre study in which a large group of patients are assessed, after recovering from the direct aftermath of head injury, but before the onset of PTE. This baseline provides an opportunity for longitudinal follow-up. Full recovery from head injury before the onset of PTE is to be expected in the mild and moderate groups of closed head injury patients. In this category, approximately 2000 head injured patients have to be assessed to obtain a resonable group of approximately 100–200 PTE patients.
- Published
- 1992
- Full Text
- View/download PDF
34. Mental deterioration at epilepsy onset: a hypothesis
- Author
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H, Meinardi, A P, Aldenkamp, and B, Nunes
- Subjects
Adult ,Epilepsy ,Adolescent ,Intelligence ,Brain ,Neuropsychological Tests ,Epilepsy, Post-Traumatic ,Risk Factors ,Brain Injuries ,Child, Preschool ,Intellectual Disability ,Humans ,Brain Damage, Chronic ,Child - Abstract
In this study, we hypothesized a type of mental deterioration in epilepsy, characterized as a discontinued, cascading process, i.e. a sudden mental decline in a limited time interval, immediately after the onset of the seizures. The posttraumatic epilepsy model (PTE) may appear to be exceptionally useful in avoiding one of the major methodological obstacles for testing this hypothesis, i.e. the unavailability of test results obtained with the same battery of tests prior to and directly after the onset of the seizures. We propose a multicentre study in which a large group of patients are assessed, after recovering from the direct aftermath of head injury, but before the onset of PTE. This baseline provides an opportunity for longitudinal follow-up. Full recovery from head injury before the onset of PTE is to be expected in the mild and moderate groups of closed head injury patients. In this category, approximately 2000 head injured patients have to be assessed to obtain a reasonable group of approximately 100-200 PTE patients. This group will be followed during the critical period of 2-3 years after the onset of epilepsy.
- Published
- 1992
35. Carbamazepine in comparative trials: Pharmacokinetic characteristics too often forgotten
- Author
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C. L. P. Deckers, Y. A. Hekster, A. Keyser, H. Meinardi, W. O. Renier, S. Arroyo, and J. W. A. S. Sander
- Subjects
Neurology (clinical) - Published
- 2000
- Full Text
- View/download PDF
36. The effect of intravenous flumazenil on interictal electroencephalographic epileptic activity: results of a placebo-controlled study
- Author
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H. Meinardi, Simon Shorvon, D. J. Nutt, Y. M. Hart, and Josemir W. Sander
- Subjects
Adult ,Flumazenil ,Male ,medicine.drug_class ,medicine.medical_treatment ,Pharmacology ,Placebo ,Partial agonist ,Epilepsy ,medicine ,Humans ,Single-Blind Method ,Infusions, Intravenous ,Evoked Potentials ,Benzodiazepine ,Diazepam ,Dose-Response Relationship, Drug ,business.industry ,Antagonist ,Brain ,Electroencephalography ,Middle Aged ,medicine.disease ,Receptors, GABA-A ,Psychiatry and Mental health ,Anticonvulsant ,Epilepsy, Temporal Lobe ,Anesthesia ,Surgery ,Anticonvulsants ,Drug Therapy, Combination ,Female ,Neurology (clinical) ,Epilepsies, Partial ,business ,medicine.drug ,Research Article - Abstract
The effect on interictal electroencephalographic epileptic activity of intravenous flumazenil (Ro 15-1788), a benzodiazepine antagonist and potential antiepileptic drug, was studied in 10 patients. Comparison was made with intravenous diazepam (10 mg) and placebo using a single-blind, single-dose, cross-over design. A dose of 3 mg flumazenil was well tolerated and produced a significantly greater reduction in the number of epileptic transients during the first 40 minutes after injection than did placebo (p less than 0.05). This effect was similar to that of diazepam in magnitude and duration. When flumazenil (3 mg) was administered immediately after intravenous diazepam (10 mg), the reduction in interictal epileptic activity was not significantly different from that produced by diazepam alone. The results suggest that either flumazenil has intrinsic antiepileptic activity and in this respect acts as a partial agonist at the benzodiazepine receptor, or that it is antagonising an endogenous proconvulsant ligand in these patients.
- Published
- 1991
37. Mental deterioration in a population with intractable epilepsy
- Author
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H, Meinardi, A M, Beun, B, Aldenkamp, B, Nunes, M, Engelsman, and E, Forceville
- Subjects
Adult ,Intelligence Tests ,Male ,Epilepsy ,Neurocognitive Disorders ,Humans ,Brain Damage, Chronic ,Dementia ,Female ,Middle Aged ,Neuropsychological Tests ,Aged ,Follow-Up Studies - Published
- 1991
38. Problems of drug therapy of epilepsy in developing countries
- Author
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B, Adamolekun and H, Meinardi
- Subjects
Epilepsy ,Phenobarbital ,Humans ,Anticonvulsants ,Community Health Services ,Rural Health ,Developing Countries ,Health Services Accessibility - Abstract
Unavailability of drug therapy to patients with epilepsy in developing countries is probably the most important obstacle to effective primary care of epilepsy in these countries. At the recent international Merritt-Putnam Symposium in New Delhi, poor availability of drug supply and poor access to drug therapy were identified as major constraints to availability of drug therapy. The extent and magnitude of the problems are examined in this communication and methods of improving drug therapy of epilepsy in developing countries are suggested.
- Published
- 1990
39. Serum protein binding of antiepileptic drugs in Sri Lankans
- Author
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E H, Karunanayake, P D, Joice, J B, Peiris, J W, Meijer, and H, Meinardi
- Subjects
Adult ,Male ,Epilepsy ,Adolescent ,Blood Proteins ,Middle Aged ,Carbamazepine ,Phenobarbital ,Phenytoin ,Humans ,Anticonvulsants ,Drug Therapy, Combination ,Female ,Protein Binding ,Sri Lanka - Abstract
The percentage protein binding of antiepileptic drugs was investigated in epileptic patients (n = 90) undergoing treatment with phenobarbitone, phenytoin and carbamazepine either as a single drug therapy or in different combinations. When administered individually, the percentage (mean +/- SEM) protein binding of phenobarbitone, phenytoin and carbamazepine were 50.84 +/- 7.03, 87.23 +/- 2.98 and 76.80 +/- 6.30 respectively. Combination of phenobarbitone and phenytoin resulted in percentage (mean +/- SEM) protein binding of 51.94 +/- 6.09 for phenobarbitone and 83.54 +/- 7.01 for phenytoin, while the combination of phenobarbitone and carbamazepine resulted in percentage (mean +/- SEM) protein binding of 49.60 +/- 2.59 for phenobarbitone and 79.10 +/- 3.31 for carbamazepine. When phenytoin was given with carbamazepine percentage (mean +/- SEM) protein binding was 87.22 +/- 4.48 for phenytoin and 72.50 +/- 5.92 for carbamazepine.
- Published
- 1990
40. [Untitled]
- Author
-
D.G.A. Kasteleijn-Nolst Trenité, H. Meinardi, and Y.A. Hekster
- Subjects
Pharmacology ,medicine.medical_specialty ,business.industry ,Outcome measurements ,Biopharmaceutics ,Pharmaceutical Science ,Pharmacy ,General Medicine ,Pharmacoepidemiology ,Toxicology ,Pharmacotherapy ,Pharmacokinetics ,medicine ,Pharmacology (medical) ,Intensive care medicine ,business - Published
- 1997
- Full Text
- View/download PDF
41. Teratogenicity of antiepileptic drugs
- Author
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H. Meinardi, J. Elshove, A.A.E. Starreveld-Zimmerman, and W.J. van der Kolk
- Subjects
Adult ,Heart Defects, Congenital ,Male ,medicine.medical_specialty ,Cleft Lip ,Epilepsy ,Pregnancy ,medicine ,Humans ,Fetal Death ,Maternal-Fetal Exchange ,Maternal-fetal exchange ,Fetal death ,Obstetrics ,business.industry ,Infant, Newborn ,Abnormalities, Drug-Induced ,General Medicine ,Middle Aged ,medicine.disease ,Infant newborn ,Abortion rate ,Teratology ,Abortion, Spontaneous ,Cleft Palate ,Pregnancy Complications ,Pregnancy Trimester, First ,Teratogens ,Anesthesia ,Anticonvulsants ,Female ,Surgery ,Neurology (clinical) ,business - Abstract
Summary A Dutch survey of teratology in 372 pregnancies in 153 outpatients of special epilepsy centres is presented. 7,4% live-born babies suffered from congenital anomalies, abortion rate was 17,7%; the rate of stillbirth 2,4%. The influence of seizures and of five groups of antiepileptic drugs is discussed. The relevant literature is reviewed.
- Published
- 1974
- Full Text
- View/download PDF
42. Oxcarbazepine (GP 47.680): A Possible Alternative to Carbamazepine?
- Author
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D. M. Goedhart, J. W. A. Meyer, R. J. E. A. Höppener, M. A. Houtkooper, H. Meinardi, J. A. R. J. Hulsman, A. Lammertsma, C. A. E. H. van Oorschot, and G. F. Blom
- Subjects
Adult ,Male ,medicine.medical_specialty ,Time Factors ,Adolescent ,Oxcarbazepine ,Double blind study ,Random Allocation ,Double-Blind Method ,Seizures ,Humans ,Medicine ,Gynecology ,Clinical Trials as Topic ,Epilepsy ,business.industry ,Carbamazepine ,Middle Aged ,Surgery ,Neurology ,Anticonvulsants ,Female ,Neurology (clinical) ,business ,medicine.drug - Abstract
Summary: A double-blind randomized crossover design trial of carbamazepine (CBZ) and oxcarbazepine (OCBZ) was performed with 48 in-patients with epilepsy. All were stabilized on polytherapy including CBZ and had at least two seizures per week. CBZ was replaced by the trial medication. Each trial period started with a titration, followed by a 12-week steady state. Concomitant medications were kept constant during the trial. The criteria for assessment were seizure fit frequency and severity; tolerability; hematology and blood chemistry; plasma levels of antiepileptic drugs; EEG; cardiovascular parameters; and treatment preference. The following differences regarding OCBZ were detected: 9% reduction of the total number of seizures, with a significant reduction of tonic-clonic (20%) and tonic (31%) seizures; increased alertness and concentration ability in five patients; an allergic skin reaction with CBZ that completely disappeared in two patients while receiving OCBZ; an increase of valproate and phenytoin plasma levels in a number of patients, probably caused by reduced enzyme induction; a slight but significant reduction of serum Na, not causing clinical symptoms; less seizures than in the CBZ period in 25 patients (52%); and a preference for OCBZ in 23 patients (48%). We consider OCBZ at least as effective as CBZ with a slightly better tolerability. In severe cases, the wider therapeutic window might improve seizure control. RESUME Une etude randomisee en double aveugle avec croisement comparant la carbamazepine (CBZ) et 'oxcarbazepine (OCBZ) a ete effectuee chez 48 patients epileptiques. Tous etaient equilibres par une polytherapie incluant la CBZ et presentaient un minimum de 2 crises par semaine. La CBZ a ete remplacee par 'OCBZ. Chaque periode 'essai debutait par une recherche de dose, suivie 'une periode 'equilibre de 12 semaines. Les traitements associes n'ont pas ete modifyes pendant 'etude. Les criteres retenus furent: frequence et severite des crises, tolerance, surveillance heamatologique et chimique, taux sanguins des medicaments, EEG, parametres cadiovasculaires et preference subjective des patients. Les differences suivantes ont ete notees pour 'OCBZ: reduction de 9% du nombre total de crises, avec reduction significative des crises tonico-cloniques (20%) et toniques (31%); 5 patients ont presente une amelioration de la vigilance et des possibilityes de concentration; 2 patients ont presente une reaction cutanee allergique a la CBZ qui a completement disparu sous OCBZ; une augmentation des taux sanguins de valproate et de phenytoine a ete constatee chez un certain nombre de patients, probablement par reduction de 'activite inductrice enzymatique; une discrete mais significative diminution de la natremie, sans traduction clinique; une diminution de la frequence des crises par rapport a la periode CBZ chez 25 patients (52%); une preference subjective pour 'OCBZ chez 23 patients (48%). Nous considerons en conclusion que 'OCBZ est au moins aussi efficace que la CBZ avec une tolerance un peu meilleure. Dans les cas severes, son spectre 'action plus etendu pourrait ameliorer le controle des crises. RESUMEN Un estudio doble-ciego, randomizado y cruzado ha sido realizado con carbamazepina (CBZ) y oxicarbamazepina (OCBZ) en 48 enfermos con epilepsyia. Todos estaban ch'nicamente estabili-zados con politerapia incluyendo CBZ y tenian, al menos, 2 ataques a la semana. La CBZ fue remplazada por la medicacion ensayada. Cada periodo de ensayo empezaba con una titulacion de la droga seguida de 12 semanas de estado constante. Las rnedicaciones concomitantes se mantuvieron en las mismas dosis durante todo el ensayo. Los criterios de estudio fueron: frecuencia y severidad de los ataques, tolerabilidad, bioquimica de sangre y estudios hematologicos, niveles plasmaticos de las medicaciones antiepilepticas, EEG, parametros cadiovasculares y preferencias en el tratamiento. Se detectaron las siguientes diferencias en relacion a la OCBZ: Una reduccion del 9% del numero total de ataques con una reduccion significativa de los tonico-clonicos (20%) y los tonicos (31%). Cinco pacientes mostraron un incremento de su estado de alerta y de la capacidad de concentracion. Dos enfermos mostraron una reaccion alergica tomando la CBZ que desaparecio completamente cuando se les administero la OCBZ. Se ha obtenido un incremento de los niveles plasmaticos de valproato y fenitoina en un numero de pacientes, probablemente debido a una reduccion de la induccion enzimatica. Se ha observado una reduccion leve pero significativa del Na serico sin que causara sintomas clinicos. Se han identificado menos ataques que durante el periodo de tratamiento con CBZ en 25 pacientes (52%). Se observo una preferencia para la ingestion de OCBZ en 23 pacientes (48%). En conclusion consideramos que la OCBZ es, al menos, tan eficaz como la CBZ con una tolerabilidad ligeramente mejor. En casos severos la ventana terapeutica mas amplia puede mejorar el control de los ataques.
- Published
- 1987
- Full Text
- View/download PDF
43. Photosensitive patients: symptoms and signs during intermittent photic stimulation and their relation to seizures in daily life
- Author
-
D.G.A. Kasteleijn-Nolst Trenité, Colin D. Binnie, and H. Meinardi
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,Light ,genetic structures ,Photic Stimulation ,Electroencephalography ,Seizures ,medicine ,Humans ,Intermittent photic stimulation ,Child ,Psychiatry ,Aged ,medicine.diagnostic_test ,Brain ,Middle Aged ,Impaired consciousness ,Psychiatry and Mental health ,Anesthesia ,Patients symptoms ,Female ,Surgery ,Neurology (clinical) ,Psychology ,Research Article - Abstract
Thirty six patients were studied with a classical photoparoxysmal EEG response to intermittent photic stimulation (IPS). Clinical observations and complaints reported by patients during standardised IPS were recorded and compared with historical data. Twenty seven patients experienced impaired consciousness or showed motor phenomena such as involuntary opening of the eyes or jerking on one or both sides of the body. Twenty five patients had sensations such as pain in the eyes, jerking etc. There existed no relation between the duration of the evoked discharges (0.5-3 seconds) and observed signs or complaints. In 11 instances the clinical features found during IPS were not reported in a history taken from the patient and relatives.
- Published
- 1987
- Full Text
- View/download PDF
44. BOOK REVIEWS
- Author
-
H. MEINARDI
- Subjects
Neurology (clinical) - Published
- 1986
- Full Text
- View/download PDF
45. [Relations to the use of antiepileptics by the pregnant woman to the development of congenital abnormalities in her child]
- Author
-
H, Meinardi
- Subjects
Pregnancy Complications ,Risk ,Epilepsy ,Pregnancy ,Hydantoins ,Phenytoin ,Infant, Newborn ,Abnormalities, Drug-Induced ,Humans ,Anticonvulsants ,Female - Published
- 1983
46. Assessment of effects of antiepileptic drugs
- Author
-
H, Meinardi, C D, Binnie, and J W, Meijer
- Subjects
Epilepsy ,Brain ,Humans ,Anticonvulsants ,Electroencephalography ,Long-Term Care ,Monitoring, Physiologic - Abstract
Pharmacological studies form an important adjunct to epilepsy monitoring and conversely long-term EEG and video recording are of value for assessing antiepileptic drug (AED) effects. Clinical estimates of the incidence of brief frequent seizures as absences is often difficult but greater reliability can be achieved by long-term monitoring of the seizures themselves or of the associated EEG discharges. There are, however, very marked spontaneous short-term fluctuations in discharge rates and the amounts of ictal epileptiform activity in short conventional EEGs rarely provide any useful index of AED action. Acute investigations are of value for assessing new AEDs or experimental methods of administration and for pharmacokinetic studies. For this purpose either spontaneous EEG discharges or photosensitivity may provide quantitative measures of antiepileptic effect. Long-term AED monitoring by means of an indwelling catheter indicates the time course of blood drug levels to be more complex and variable than might be expected from simple pharmacokinetic models. Short-term fluctuations in AED concentrations have little effect on epileptiform EEG activity or seizure control but are often responsible for intermittent side-effects. Conversely diagnostic EEG and monitoring studies may be required to classify seizures as an aid to determining appropriate medication and may explain apparent resistance to therapy, due to pseudo-seizures, reflex or self-induced epilepsy. Finally a case is presented for combined pharmacological EEG and video-monitoring in the preliminary assessment of new AEDs in order to improve the design of subsequent clinical trials.
- Published
- 1985
47. Evaluation of a new immunoassay for determination of phenytoin and phenobarbital: results of a European collaborative control study
- Author
-
P. J. M. Guelen, E. v. d. Kleijn, H. Meinardi, J. W. A. Meijer, Y. Stein-Lavie, N. Symann-Louette, Svein I. Johannessen, H. Schneider, V. Goldberg, Dieter Schmidt, and Alan Richens
- Subjects
Enzyme multiplied immunoassay technique ,Immunoassay ,Chromatography ,Chromatography, Gas ,medicine.diagnostic_test ,Chemistry ,Glucosephosphate Dehydrogenase ,Serum samples ,Neurology ,Phenobarbital ,Phenytoin ,medicine ,Humans ,Neurology (clinical) ,Chromatography, Thin Layer ,Beneficial effects ,Leuconostoc - Abstract
SUMMARY The performance of a new enzyme multiplied immunoassay technique (EMIT) was compared with other current methods, namely gas-liquid chromatography and thin-layer chromatography, for the determination of phenytoin and phenobarbital in serum. Forty-three serum samples were sent as unknowns to the participating laboratories for determination. The precision of repeated determinations was very similar for EMIT and chromatography. There was good agreement among gas chromatography, thin-layer chromatography, and EMIT results. Interlaboratory variability was lower for EMIT determinations of both an-tiepileptic drugs. The rapid analysis of small samples, made possible by the EMIT system, could have beneficial effects on the treatment of epilepsies. RESUMEN Se han determinado los niveles en suero de di-fenilhidantoina y fenobarbital mediante una nueva tecnica de medicion de enzimas con immunoensayo mul-tiplicado (EMIT) y los resultados se han comparado con otros mdtodos actuates y fundamentalmente con cromatografia de gas-liquido y cromatografia de capa fina. Se enviaron 43 muestras sin codificar a los laboratorios participantes. La precision de las deter-minaciones repetidas fue muy semejante entre la EMIT y la cromatografia con una buena correlation entre las diversas teacnicas. La variabilidad entre los laboratorios fue menor, utilizando la EMIT. La rapidez del analisis y las minimas dosis utilizadas pueden contribuir beneficiosamente en el tratamiento de las epilepsias. ZUSAMMENFASSUNG Eine neue enzymatische Immunoassaytechnik (EMIT) wurde mit anderen gangigen Methoden z.B. der Gaschromatographie und der Dunnschichtchro-matographie zur Bestimmung von Diphenylhydantoin und Phenobarbital im Serum verglichen. 43 Serum-proben wurden ungekennzeichnet den teilnehmenden Labors zur Bestimmung ilbersandt. Die Genauigkeit von wiederholten Bestimmungen war fur die EMIT und die chromatographische Methode sehr ahnlich. Es bestand eine gute Ubereinstimmung der Resultate, die durch Gaschromatographie, Dunnschichtchroma-tographie und die EMIT-Methode erzielt wurden. Die Unterschiede zwischen den Labors waren geringer fur die EMIT-Bestimmungen beider Antiepileptika. Die schnelle Analyse kleiner Mengen, die das EMIT-System erlaubt, konnte sich vorteilhaft in der Epilepsiebe-handlung auswirken.
- Published
- 1977
48. [Use of valproic acid in pregnancy: an indication for prenatal diagnosis of spina bifida]
- Author
-
D, Lindhout and H, Meinardi
- Subjects
Pregnancy Complications ,Risk ,Epilepsy ,Pregnancy ,Prenatal Diagnosis ,Valproic Acid ,Infant, Newborn ,Abnormalities, Drug-Induced ,Humans ,Female ,Spina Bifida Occulta - Published
- 1984
49. Spina bifida and in-utero exposure to valproate
- Author
-
H. Meinardi and D. Lindhout
- Subjects
medicine.medical_specialty ,Pregnancy ,Epilepsy ,business.industry ,Obstetrics ,Spina bifida ,Valproic Acid ,Abnormalities, Drug-Induced ,General Medicine ,Spina Bifida Occulta ,medicine.disease ,Pregnancy Complications ,In utero ,Medicine ,Humans ,Female ,business - Published
- 1984
50. [Clinical evaluation of EEG telemetry and videomonitoring in 212 patients with epilepsy]
- Author
-
J, Overweg, C D, Binnie, P, van der Geest, H, Meinardi, J A, van Parys, A J, Rowan, T, Wisman, A, Kamp, and F, Lopes da Silva
- Subjects
Adult ,Epilepsy ,Time Factors ,Adolescent ,Child, Preschool ,Humans ,Telemetry ,Videotape Recording ,Electroencephalography ,Middle Aged ,Child - Published
- 1981
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