Open, Double-Blind and Long-Term Study of Vigabatrin in Chronic Epilepsy

We performed an open, double-blind, and long-term study of vigabatrin (gamma-vinyl-GABA, GVG) in patients with treatment-resistant epilepsy who were receiving only one or at most two standard antiepileptic drugs (AEDs). The novel design included a parallel, double-blind, placebo-controlled phase that minimized the number of patients receiving placebo and allowed determination of the optimum dose of GVG for each patient before initiation of the double-blind phase. The study was divided into four phases. The first phase was a 6-week period of baseline observation. In the second phase, GVG was added openly to previous AEDs for 8 weeks. During the first 2 weeks of this phase, the dose of GVG was increased weekly and then, in the absence of adverse effects, was held constant for the next 6 weeks. At the end of this open phase, seizure frequency during the 6 weeks of constant treatment was compared with the baseline seizure frequency for each patient. Patients who experienced reduction greater than 50% in the frequency of any seizure type during the open phase were defined as responders. These responders were then entered into the third and double-blind phase, in which they were randomly allocated wither to continue active GVG treatment or placebo for 8 weeks. Thirty-three patients entered the study; 31 of 33 patients completed the initial open phase. Twenty patients achieved a reduction greater than or equal to 50% in the frequency of one or more seizure types and were eligible for the double-blind phase; 10 were randomized to continue GVG and 10 were randomized to placebo.(ABSTRACT TRUNCATED AT 250 WORDS)     

Origin of olfacto-gustatory alliesthesia: Intestinal sensitivity to carbohydrate concentration?

Gustatory and olfactory alliesthesia was observed in nine healthy adult humans who received on three different days an intragastric load of 50 g glucose dissolved into various amounts of water in order to make 100, 200 and 400 ml of solution. Maximal alliesthesia to sweet stimuli was observed with the smallest volume, i.e., highest concentration. Comparison of these results with previous results [7], obtained not by varying the volume but by varying the glucose mass, shows identity. Maximal alliesthesia to olfactory anchovy and Viandox^R was also observed after ingestion of the most concentrated gastric load. Maximal negative alliesthesia was observed about 45 min after the gastric load; thereafter alliesthesia tended to decrease. A gastric 200 ml load containing 40 g Mannitol, a nonabsorbed sugar, was followed by a strong negative alliesthesia to alimentary stimuli. Ten g glucose in 20 ml solution produced a more intense and rapid alliesthesia when injected into the duodenum than when injected into the stomach. It may be concluded that postinjective negative alliesthesia for alimentary stimuli can be caused by intraduodenal concentration of nutrients, probably sensed by duodenal nervous chemoreceptors.     

Influence of a monotonous food on body weight regulation in humans

Four human subjects were fed ad lib with a bland diet for a period of 3 weeks. Their body weight decreased by 3.13 kg during this period. It was observed that the shift of the palatability response to sucrose solutions induced by a gastric glucose load (alliesthesia) was not affected by such a reduction of body weight. This result was compared to a previous experiment showing a decreased alliesthesia after a body weight loss due to the restriction of a palatable diet. These results confirm the role of the palatability of the diet on the maintenance of a body weight level and provide evidence for an interaction between the two factors in determining the oral satiation process.