melphalan and Epilepsy

Sister-chromatid exchanges (SCEs) and cell kinetics in cultured lymphocytes of patients with an initial epileptic attack, and prior to any anticonvulsant treatment, were studied. Spontaneous melphalan (MEL) and MEL-hyperthermia (MEL-HYP) induced SCE frequencies have been studied in 18 adults with an initial epileptic seizure. Fifteen age and sex matched healthy subjects were used as the control group. The incidence of spontaneous SCEs in lymphocytes from epileptics was not significantly greater than in those from the control subjects. However, when exposed to MEL in vitro, cells from both groups showed an increase in SCE frequency. When exposed to MEL and HYP (41 degrees C for 3 h) in vitro, cells from both groups showed a further increase in SCE frequency with yields from epileptics higher (P less than 0.05) than from controls. HYP in combination with MEL enhanced synergistically SCEs and cell division delays in both groups with synergistic effects in cells from epileptics (P less than 0.01 and P less than 0.01 respectively) higher than from controls (P less than 0.05 and P less than 0.05 respectively.

Topics: Adult; Aged; Cells, Cultured; Cold Temperature; DNA Repair; Epilepsy; Female; Humans; Lymphocytes; Male; Melphalan; Middle Aged; Sister Chromatid Exchange

Essential thrombocythemia is a clonal myeloproliferative disorder, characterized predominantly by a markedly elevated platelet count without known cause. We report a case that was recognized during investigation of a transient ischemic attack, and review the neurologic findings in 33 patients with unequivocal essential thrombocythemia under prospective study by the Polycythemia Vera Study Group. Twenty-one patients had neurologic manifestations at some point during their course, including headache (13 patients), paresthesiae (10), posterior cerebral circulatory ischemia (9), anterior cerebral circulatory ischemia (6), visual disturbances (6) and epileptic seizures (2). All patients with neurologic symptoms responded satisfactorily to treatment, although continuous or repeated treatment was often required. Therapeutic recommendations include plateletpheresis for major thrombo-hemorrhagic phenomena, or megakaryocyte suppression with radioactive phosphorus, alkylating agents (such as melphalan), or hydroxyurea; minor symptoms may respond to platelet antiaggregating agents.

Topics: Adult; Epilepsy; Female; Headache; Humans; Ischemic Attack, Transient; Melphalan; Paresthesia; Platelet Count; Plateletpheresis; Prospective Studies; Thrombocythemia, Essential; Vision Disorders