potassium-bromide and Epilepsy--Tonic-Clonic

This study investigated the efficacy and tolerability of potassium bromide in 113 patients (aged, 1-20 years) with severe epilepsy and generalized tonic-clonic seizures. Potassium bromide was started at 45 mg/kg and raised to 70 mg/kg (median). Steady-state blood level was reached after a median of 28 days (range, 5-95 days). The number of patients who had suffered generalized tonic-clonic seizures during the last month dropped from 82 to 41, and the median frequency, dropped from 4.5 to 0 per month. Of the patients with generalized tonic-clonic seizures during baseline, 49% showed none in the last 4 weeks of the study, and another 31% showed a reduction by more than 50%. Potassium bromide should have a place as a drug of tertiary choice in the treatment of children with epilepsy. Experience with the drug and close clinical and pharmacologic monitoring are necessary to achieve the greatest possible benefit and avoid side effects.

Topics: Adolescent; Adult; Anticonvulsants; Bromides; Child; Child, Preschool; Drug Tolerance; Electroencephalography; Epilepsy, Generalized; Epilepsy, Tonic-Clonic; Female; Humans; Infant; Longitudinal Studies; Male; Potassium Compounds; Retrospective Studies; Time Factors

Topics: Adolescent; Anticonvulsants; Bromides; Child; Child, Preschool; Drug Evaluation; Drug Therapy, Combination; Epilepsies, Myoclonic; Epilepsies, Partial; Epilepsy, Tonic-Clonic; Humans; Male; Potassium Compounds; Retrospective Studies; Treatment Outcome

Necrotizing panniculitis due to potassium-bromide is a drug induced allergic reaction following stimulation of lymphocytes as demonstrated for the first time by a lymphocyte transformation test (LTT). We named the disease "halogen panniculitis" because of similar generally known reactions to iodides and describe the typical symptoms in three own cases. Bromoderma tuberosum tends to be a similar kind of allergy. For the first time pancreatitis to potassium bromide in men has been observed, which has already been described in epileptic dogs treated with potassium bromide.

Topics: Adipose Tissue; Adolescent; Biopsy; Bromides; Child; Drug Therapy, Combination; Epilepsy, Tonic-Clonic; Female; Humans; Male; Necrosis; Panniculitis; Phenytoin; Potassium Compounds; Skin

In recent years potassium bromide has again been used with increasing frequency in the treatment of epilepsy. A 3-year-old girl with bromoderma tuberosum following such treatment is described; the symptoms disappeared after reduction of the bromide dose.

Topics: Anticonvulsants; Bromides; Child, Preschool; Dose-Response Relationship, Drug; Drug Eruptions; Epilepsy, Tonic-Clonic; Female; Humans; Potassium; Potassium Compounds; Status Epilepticus

In therapy lasting between 8 and 79 (means = 31) months 22 epileptic dogs had been unsuccessfully treated with phenobarbital and/or primidone. Both drugs had been administered in their maximum dosages. In an add-on therapy, these dogs were given potassium bromide at a rate of 17 to 58 mg/kg daily for a period of 7 to 61 (means = 21) months. We could quantitatively evaluate the seizure data from 19 of the dogs: four became free of seizures; seven showed a greater than 50% reduction in seizure frequency; in two dogs, the seizures were reduced by greater than 50% but the number of seizure-days by less than 50%; in the remaining six dogs the therapy was unsuccessful. We achieved the best therapeutic results in animals that suffered only grand mal seizures. Grand mal in addition to other types of seizures and tonic seizures were affected to a lesser extent if at all. At the beginning of the therapy we saw temporary side effects--weakness in the hind limbs and sedation; these were temporary and dependent on the dosage. Serum concentrations differed even with the same dosage among individual dogs. The therapeutic range of bromide serum concentration was from 0.7 to 2.0 mg/ml. Most of the animals tolerated concentrations up to 1.5 mg/ml quite well. To begin an add-on therapy with potassium bromide we would recommend a daily dose of 30 to 40 mg/kg. During treatment, the dose should be determined for each individual dog.

Topics: Animals; Bromides; Dog Diseases; Dogs; Dose-Response Relationship, Drug; Drug Resistance; Epilepsy; Epilepsy, Tonic-Clonic; Female; Male; Phenobarbital; Potassium; Potassium Compounds; Primidone

Topics: Adolescent; Adult; Anticonvulsants; Bromides; Child; Child, Preschool; Drug Therapy, Combination; Electroencephalography; Epilepsies, Partial; Epilepsy; Epilepsy, Tonic-Clonic; Evoked Potentials; Female; Humans; Male; Potassium; Potassium Compounds