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Routine Screening of Blood and Urine for Severe Anticonvulsant Reactions in Asymptomatic Patients is of Doubtful Value

Published online by Cambridge University Press:  18 September 2015

Peter Camfield ,
Carol Camfield ,
Joseph Dooley ,
Kevin Farrell ,
Pierre Langevin  and
Peter Humphreys
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Abstract:

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On rare occasions anticonvulsant medication may cause severe or fatal toxic reactions. This position paper, approved by the Canadian Association for Child Neurology, examines the value of routine blood and urine screening to prevent catastrophic reactions in asymptomatic patients. The basic assumptions of such a screening program are faulty or unproven. Although not definitive, available studies of screening do not appear to support its value. It is recommended that routine blood and urine screening be discontinued in asymptomatic patients. Until such time as further research is able to identify patients at special risk, it is suggested that patients be carefully informed of the early symptoms of severe toxic reactions and report these immediately to a physician.

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Canadian Journal of Neurological Sciences , Volume 16 , Issue 3 , August 1989 , pp. 361 - 363
Copyright
Copyright © Canadian Neurological Sciences Federation 1989

References

REFERENCES

1.DeVries, SI. Haematological aspects during treatment with anti-convulsant drugs. Epilepsia 1965; 6: 1–15.Google Scholar
2.Compendium of Pharmaceuticals and Specialties. Canadian Pharmaceutical Association 1988. Southam Murray. Toronto.Google Scholar
3.Physicians’ Desk Reference. Medical Economics Co., Oradell. N.J., 1988.Google Scholar
4.Schmidt, D. Adverse effects of antiepileptic drugs. New York: Raven Press, 1982.Google Scholar
5.Spielberg, S, Gordon, G, Blake, D, Goldstein, D, Herlong, A. Predisposition to phenytoin hepatotoxicity assessed in vitro. N Engl J Med 1981; 305: 722–8.CrossRefGoogle ScholarPubMed
6.Gerson, W, Fine, S, Speilberg, S, Sensenbrenner, L. Anticonvulsant-induced aplastic anemia: increased susceptibility to toxic drug metabolites in vitro. Blood 1983; 61: 8. 889–893.CrossRefGoogle ScholarPubMed
7.Fenichel, GM. Valproate hepatotoxicity: two new cases, a summary of others and recommendations. Pediatric Neurology 1985; 1: 109–13.CrossRefGoogle Scholar
8.Delattre, JT, Safai, B, Posner, JB. Erythema multiforme and Stevens-Johnson Syndrome in patients receiving cranial irradiation and phenytoin. Neurology 1988: 38: 194–197.CrossRefGoogle ScholarPubMed
9.Camfield, C, Camfield, P. Smith, E, Tibbies, JAR. Asymptomatic children with epilepsy: Little benefit from screening for anticon-vulsant-induced liver, blood or renal damage. Neurology 1986; 36: 838–841.CrossRefGoogle ScholarPubMed
10.Mattson, RH, Cramer, JA, Collins JF and the VA Epilepsy Cooperative Study Group. Connective tissue changes, hypersensitivity rash and blood laboratory test changes associated with antiepileptic drug therapy. Annals of Neurology 1986; 20: 119–120 (Abstract).Google Scholar
11.Silverstein, FS, Boxer, L, Johnstone, M. Hematological monitoring during therapy with carbamazepine in children. Annals of Neurology 1983; 13: 685 (letter).CrossRefGoogle ScholarPubMed
12.Willmore, LJ. Wilder, BJ, Bruni, J. Villareal, HJ. Effect of valproic acid on hepatic function. Neurology 1978; 28: 961–4.CrossRefGoogle ScholarPubMed
13.Physicians’ Desk Reference. Medical Economics Co., Oradell. N.J., 1988. p. 989.Google Scholar
14. Ibid. p. 511.Google Scholar
15.Dreifus, FE, Santilli, N, Langer, DH, Sweeney, KP, Moline, KA, Menander, KB. Valproic acid fatalities: A retrospective review. Neurology 1987; 37: 379–385.CrossRefGoogle Scholar