NEUROLOGICAL DISTURBANCES(1)

Headache is a common complaint of patients on anticonvulsant therapy, although some anticonvulsants such as valproic acid and gabapentin are used in migraine prophylaxis. Carbamazepine and ethosuximide are more frequently associated with this side effect than other anticonvulsants.

Dose-related tremor occurs in 10% of adults and 15% of children on valproic acid. This tremor is rhythmic, rapid, symmetrical and most prominent in the upper extremities. Low doses of propranolol may reduce the tremor ; however, dose reduction is the preferred approach.

Dyskinesias involving the face, limbs and trunk have been reported with phenytoin, usually if used as polytherapy or after an increase in the dose. Peripheral neuropathy may develop in up to 30% of institutionalized epileptics taking phenytoin. The neuropathy improves upon drug discontinuation. Other neurological effects include carbamazepine-induced dystonia, and asterixis associated with carbamazepine or valproic acid therapy. Impairment of coordination, often manifesting as limb or gait ataxia, is a common dose-related adverse effect of phenytoin. You can soon shop with a nice pharmacy offering buy generic Tavist online to benefit more.

Most anticonvulsants are associated with sedation, especially upon initiation of therapy. Carbamazepine is considered to have the least sedative effect. Sedation is the most prominent dose-dependent acute adverse effect, experienced by approximately 70% of patients on phenobarbital. Partial tolerance develops in most patients during chronic therapy. Sedation, drowsiness, dizziness and lethargy are common acute dose-related adverse effects of the benzodiazepines. As with other anticonvulsants, during chronic administration, tolerance to the central nervous system adverse effects usually develops. The most common adverse effects in patients treated with topiramate are dizziness, mental slowing, somnolence, ataxia, fatigue and confusion; these are related to rapid increases in dosage. Valproic acid is also commonly associated with sedation, especially at higher serum concentrations. Although sedation occurs with la-motrigine or valproic acid in children, attentional and performance effects are rarely affected.