Initiation of carbamazepine therapy in partial epilepsy: a regional cerebral blood flow study

The effect of the initiation of carbamazepine (CBZ) treatment on regional cerebral blood flow (rCBF) was studied using the intravenous Xenon technique in a group of epileptic patients suffering from complex partial seizures. A slight increase in mean rCBF (10.8 +/- 8.8%, P less than 0.01) was observed in 12 patients after the first month of CBZ treatment, while no rCBF change was found after 6 months of CBZ treatment. Regional analysis showed that the rCBF increase following 1 month of CBZ treatment involved all cortical regions with the exception of the right occipital region, irrespective of the initial value. Repeated rCBF measurements performed in normal volunteers (N = 6) and in epileptic patients (N = 10), chronically treated and not subjected to therapeutic modification, showed no significant change. The initial effect of CBZ on CBF found at the onset of the treatment but not after 4-6 months may be related to the improvement in epilepsy and in cerebral function (as suggested by cognitive findings).