Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Mephenytoin: a reappraisal.

A S Troupin, L M Ojemann, C B Dodrill

    Epilepsia
    |December 1, 1976
    PubMed
    Summary

    Mephenytoin (Mesantoin) serum levels, including its metabolite nirvanol, correlate with seizure control and side effects. Total mephenytoin levels between 25-40 mug/ml improve seizure control with minimal side effects, suggesting wider use for refractory epilepsy.

    Related Concept Videos

    You might also read

    Related Articles

    Articles linked to this work by shared authors, journal, and citation graph.

    Sort by
    Same author

    Effects of topiramate and gabapentin on cognitive abilities in healthy volunteers.

    Neurology·2005
    Same author

    When might hemispheric favouring of epileptiform discharges begin?

    Seizure·2003
    Same author

    Age at focal epilepsy onset varies by sex and hemispheric lateralization.

    Neurology·2003
    Same author

    Atypical speech is rare in individuals with normal developmental histories.

    Neurology·2003
    Same author

    Is the left cerebral hemisphere more prone to epileptogenesis than the right?

    Epileptic disorders : international epilepsy journal with videotape·2001
    Same author

    Test-retest bias, reliability, and regression equations for neuropsychological measures repeated over a 12-16-week period.

    Journal of the International Neuropsychological Society : JINS·2001

    Area of Science:

    • Clinical Pharmacology
    • Neuroscience
    • Pharmacokinetics

    Background:

    • Mephenytoin (Mesantoin) is an anticonvulsant medication.
    • Understanding the relationship between serum drug levels and clinical outcomes is crucial for effective treatment.
    • Previous studies have not fully elucidated the optimal therapeutic range and side effect profile of mephenytoin.

    Purpose of the Study:

    • To correlate serum levels of mephenytoin and its metabolite nirvanol with treatment effectiveness and side effects in patients with seizure disorders.
    • To determine the optimal therapeutic window for mephenytoin therapy.
    • To assess the safety and cognitive effects of mephenytoin treatment.

    Main Methods:

    • Serum concentrations of mephenytoin and nirvanol were measured in 93 patients.
    • Clinical effectiveness (seizure frequency) and side effects were systematically recorded.
    • Psychological tests were used to evaluate cognitive-attentional skills.

    Main Results:

    • The mean mephenytoin level was 8% of the combined mephenytoin plus nirvanol levels.
    • Total mephenytoin levels of 25 to 40 mug/ml were associated with improved seizure control in three-quarters of patients, with minimal discomfort.
    • While side effects common to phenytoin were absent, drowsiness, rash, and one case of aplastic anemia were observed. Cognitive-attentional skills showed modest improvement.

    Conclusions:

    • Total mephenytoin serum levels, rather than individual component levels, are better correlated with clinical outcomes.
    • A therapeutic range of 25-40 mug/ml for total mephenytoin appears effective and generally well-tolerated.
    • Mephenytoin shows promise for refractory seizure disorders, necessitating careful patient monitoring due to potential serious side effects like aplastic anemia.

    Related Experiment Videos