CLINICAL STUDIES ON THE EEG‐ACTIVATING EFFECTS OF A NEW CENTRAL STIMULANT, SODIUM‐BETA, BETA‐PENTAMETHYLENE‐GAMMA‐HYDROXYBUTYRATE

Abstract

SummaryThe activating effects of a new central stimulant, sodium‐beta, beta‐pentamethy‐lene‐gamma‐hydroxybutyrate (PHB), were examined on a total of 129 patients (composed of 56 epileptics and 73 non‐epileptics) who had almost normal resting electroencephalograms.PHB was intravenously administered at the rate of 2.5 mg per minute of 0.1% solution up to the maximum 20 mg. 44 cases out of 56 epileptics (78.6%) as well as 14 out of 73 non‐epileptics (19.2%) showed paroxysmal discharges including spikes, spike and wave complex, multiple spikes and wave complex and high voltage slow burst; nearly all the known characteristic forms of epileptic seizure patterns were produced. The activating effect of PHB seemed to be most remarkable for the centrencephalic seizure discharge in the epileptic EEG.Clinical attacks were unwittingly provoked with PHB in only four cases of epilepsy, and they all closely resembled the habitual seizures of the patients. This suggests the possibility of using PHB for the production of clinical attacks for diagnostic purposes.In 18 patients, the activating effect of PHB was compared with that of Metrazol at intervals of several weeks and 20 mg of PHB proved to have an EEG activating potency approximately identical toL that of 400 mg of Metrazol. In comparison with Metrazol, it should be emphasized that PHB seemed to have several practical advantages, especially in regard to the lesser side effects at the dosage employed, and the great margin between the threshold of seizure discharge and that of clinical attack.From the results obtained, the authors recommend provocation with a slow intravenous injection of PHB as an effective and safe procedure to obtain additional information in the EEG to establish a positive diagnosis of epilepsy in patients with suspected seizures.