gastrins and Epilepsy

The authors demonstrate three patients--two with a nesidioma of the B-cells with insulin production, the third had a nesidioma made up of non-B cells with clinical manifestations of gastrin hypersecretion. The surgical solution was successful in the patients with B-cell nesiodiomas.

Topics: Adolescent; Adult; Epilepsy; Female; Gastrins; Humans; Insulin; Insulin Secretion; Insulinoma; Male; Pancreatic Neoplasms; Zollinger-Ellison Syndrome

We have identified ten children who developed gastritis after prolonged anticonvulsant therapy that included either valproic acid or divalproex sodium. Presenting symptoms were primarily feeding difficulties, including anorexia and refusal to eat. Vomiting was present in two thirds of the patients, with diarrhea, weight loss, and abdominal pain occurring less frequently. Occult blood in stool samples was a late development. All patients responded to therapy with H2-receptor antagonists, oral antacids, or both, with prolonged treatment often necessary to prevent relapse. Although gastrointestinal tract side effects are common with the initiation of valproate sodium therapy, feeding difficulties after long-term treatment are less common. Gastritis should be suspected in children receiving valproate therapy when feeding difficulties arise, particularly if the symptoms are persistent or recurrent.

Topics: Adolescent; Antacids; Anticonvulsants; Child; Child, Preschool; Drug Therapy, Combination; Epilepsy; Female; Gastrins; Gastritis; Histamine H2 Antagonists; Humans; Male; Phenytoin; Valproic Acid