Hammond E J, Ballinger W E, Lu L, Wilder B J, Uthman B M, Reid S A
Neurology Service, Veterans Affairs Medical Center, Gainesville, FL 32608-1197.
Epilepsy Res. 1992 Sep;12(3):261-5. doi: 10.1016/0920-1211(92)90080-d.
Chronic administration of the experimental antiepileptic drug vigabatrin (gamma-vinyl GABA) to animals has been shown to cause dose-dependent neuropathological changes characterized by a microvacuolation in specific white matter tracts. This finding has led to some concern as to whether similar pathologic changes might occur in patients taking this medication. Here we report on analysis of tissue specimens taken during neurosurgery from three patients undergoing chronic vigabatrin therapy (4 g/day). The first patient, a 34-year-old woman, had taken vigabatrin for 2 years prior to surgery, the second, a 50-year-old man, had taken the drug for 1 year, and a 34-year-old man had taken the drug for 5.3 years. For comparison, similar specimens were taken from three other patients not taking vigabatrin who were undergoing surgery for intractable epilepsy. Specimens from each subject were prepared in an identical manner and examined with light and electron microscopy. All specimens were examined in a blinded fashion. There was some minor nonspecific myelinic splitting seen in both controls and vigabatrin-treated patients but there was no evidence for any drug-induced lesions similar to that seen in experimental animals.
对动物长期施用实验性抗癫痫药物氨己烯酸（γ-乙烯基 GABA）已显示会导致剂量依赖性神经病理学变化，其特征为特定白质束出现微空泡形成。这一发现引发了人们对服用该药物的患者是否可能出现类似病理变化的担忧。在此，我们报告对三名接受氨己烯酸长期治疗（4克/天）的患者在神经外科手术期间采集的组织标本的分析情况。第一名患者是一名34岁女性，在手术前服用氨己烯酸2年；第二名患者是一名50岁男性，服用该药物1年；第三名34岁男性服用该药物5.3年。作为对照，从另外三名因顽固性癫痫接受手术但未服用氨己烯酸的患者身上采集了类似标本。每个受试者的标本均以相同方式制备，并通过光学显微镜和电子显微镜进行检查。所有标本均在盲法下进行检查。在对照组和接受氨己烯酸治疗的患者中均观察到一些轻微的非特异性髓鞘分裂，但没有证据表明存在任何与实验动物中所见类似的药物诱导性病变。
