Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · Jun 1994
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialA multicentre comparative trial of sodium valproate and carbamazepine in adult onset epilepsy. Adult EPITEG Collaborative Group.
The long-term efficacy and safety of sodium valproate and carbamazepine in adult outpatients with newly diagnosed primary generalised or partial and secondarily generalised seizures were compared in a randomised, open, multicentre study at 22 neurology outpatient clinics. Patients were randomised to oral sodium valproate (Epilim EC enteric coated 200 mg tablets twice daily, n = 149) or oral carbamazepine (100 mg twice daily increasing to 200 mg twice daily in week 2, n = 151) and followed up for three years. If clinically necessary, dosages were regularly increased until seizures were controlled or toxicity developed. ⋯ At the end of the three year trial period, over 70% of the available patients were still on randomised treatment or had recently stopped treatment after achieving full seizure control. Sodium valproate and carbamazepine were both associated with a high degree of overall seizure control regardless of seizure type and both have good long-term tolerability in adult patients with newly diagnosed epilepsy. Recommendations are made for a higher initial dosage regime for sodium valproate in partial seizures.
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J. Neurol. Neurosurg. Psychiatr. · Nov 1993
Randomized Controlled Trial Comparative Study Clinical TrialMethylprednisolone in multiple sclerosis: a comparison of oral with intravenous therapy at equivalent high dose.
A randomised double-blind placebo-controlled trial of intravenous methylprednisolone versus oral methylprednisolone at equivalent high dose was carried out on 35 patients with an acute relapse of multiple sclerosis (MS). After baseline evaluation each was randomly allocated to oral treatment and intravenous placebo or intravenous treatment and oral placebo, receiving 500 mg of methylprednisolone for five consecutive days and with reassessment at days five and twenty-eight. ⋯ Adverse effects were minor and equally distributed. In this study oral treatment with methylprednisolone was as effective as intravenous treatment in acute relapse of MS.
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J. Neurol. Neurosurg. Psychiatr. · Nov 1989
Randomized Controlled Trial Comparative Study Clinical TrialEffect of the knee-chest position on cerebral blood flow in patients undergoing lumbar spinal surgery.
The cerebral haemodynamic effect of the knee-chest position was evaluated in 15 anaesthetised patients undergoing elective lumbar disc surgery and divided into a control group (n = 8) where cerebral blood flow (CBF) was measured twice in the supine position and an experimental group (n = 7) where the first CBF was measured in the supine position and the second in the knee-chest position. CBF was measured by a modified intravenous 133xenon washout technique. Mean global CBF did not change in control group (56.1, SD 9.2 versus 52.8, SD 10.8 units) and was not significantly modified by the knee-chest posture, 51.8, SD 8.8 units versus 53.9, SD 7.4 units in the supine position. The results indicate that mean global CBF in the knee-chest position is not different from CBF in the supine position in healthy patients.