Lack of effect of histological lesions on the phenytoin and phenobarbital concentrations in the brain cortex of epileptic patients

Journal of the Neurological Sciences
R SchnabelR Villagrán

Abstract

Postmortem concentrations of phenytoin (PHT) and phenobarbital (PB) were determined in 24 specimens of the frontal, temporal, occipital or neocerebellar cortex with different pathological changes and in the serum (total and free) from 11 epileptic patients. The cortical lesions were characterized by various degrees of neuronal loss or necrosis associated with other changes such as proliferated gliocytes, fibre gliosis, Rosenthal fibres or numerous corpora amylacea. According to other investigators neurons are the main binding sites of PHT and PB in rodent brains. The PHT and PB concentrations in 20 cortical lesions from nine patients were not significantly reduced as compared to the data of 46 deceased epileptic control patients. A significantly decreased PB value could only be demonstrated in the temporal specimen of an old scarred infarction with complete demyelination. On the other hand a slight but significant increase of PB was observed in three neocortical samples from a child exhibiting severe brain oedema and thrombosis of the sinuses. The results favour the unspecific binding of PHT and PB to cerebral tissue constituents and do not support the hypothesis of major binding to specific receptors.

References

May 1, 1976·Acta Neurologica Scandinavica·L P PertschukD J Brigati
Jan 1, 1989·Epilepsy Research·P N FrielG Van Belle
Dec 1, 1973·Biochemical Pharmacology·M A Goldberg, T Todoroff
Apr 1, 1972·Canadian Journal of Physiology and Pharmacology·A J Wilensky, J A Lowden
May 1, 1971·European Journal of Pharmacology·T Nielsen, C Cotman
Jul 1, 1994·Epilepsy Research·R D ScheyerR H Mattson

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