Document Detail

Computerized tremor analysis of valproate-induced tremor: a comparative study of controlled-release versus conventional valproate.
MedLine Citation:
PMID:  15679514     Owner:  NLM     Status:  MEDLINE    
PURPOSE: Valproate (VPA) induces postural tremor in 6-45% of patients. The characteristics of VPA-induced tremor have not yet been quantitatively assessed, and it is not known whether tremor prevalence or severity is affected by VPA formulation (controlled-release CR-VPA vs. conventional VPA). The aim of this study was quantitatively to assess tremor in epilepsy patients receiving VPA and to compare the effects of two VPA formulations (CR-VPA vs. VPA) on tremor severity. METHODS: In a prospective study, 18 consecutive patients with newly diagnosed focal or generalized epilepsy were assigned to receive alternately either VPA (n=10) or CR-VPA (n=8) monotherapy. Computerized tremor analysis was performed at baseline 1 day before initiating VPA treatment and repeated after a seizure-free period of >or=8 weeks, during which VPA doses had remained stable. Rest and postural tremor were recorded by accelerometry, and surface electromyograms (EMGs) were recorded from the wrist flexors and extensors. RESULTS: At baseline, the two groups had similar postural tremor amplitudes. At follow-up, the CR-VPA group had remained at the same level, whereas VPA subjects exhibited a significant increase in tremor amplitudes (p<0.05) despite comparable VPA doses and comparable plasma VPA concentrations at the time of tremor testing. CONCLUSIONS: This is the first study to assess quantitatively VPA-induced tremor by standardized tremor analysis. These results suggest that CR-VPA may cause less tremorigenic activity as compared with standard VPA. The mechanisms underlying this difference are unclear but may include greater peak-trough variation with VPA than with CR-VPA.
Martina Rinnerthaler; Gerhard Luef; Joerg Mueller; Klaus Seppi; Joerg Wissel; Eugen Trinka; Gerhard Bauer; Werner Poewe
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article    
Journal Detail:
Title:  Epilepsia     Volume:  46     ISSN:  0013-9580     ISO Abbreviation:  Epilepsia     Publication Date:  2005 Feb 
Date Detail:
Created Date:  2005-01-31     Completed Date:  2005-03-09     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  2983306R     Medline TA:  Epilepsia     Country:  United States    
Other Details:
Languages:  eng     Pagination:  320-3     Citation Subset:  IM    
Department of Neurology, Innsbruck Medical University, Austria.
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MeSH Terms
Activities of Daily Living / classification
Anticonvulsants / administration & dosage*,  adverse effects*
Delayed-Action Preparations
Diagnosis, Computer-Assisted
Disability Evaluation
Epilepsy / drug therapy*
Follow-Up Studies
Middle Aged
Prospective Studies
Severity of Illness Index
Tremor / chemically induced*,  diagnosis*
Valproic Acid / administration & dosage*,  adverse effects*
Reg. No./Substance:
0/Anticonvulsants; 0/Delayed-Action Preparations; 99-66-1/Valproic Acid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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