LACK OF EFFECT OF HISTOLOGICAL LESIONS ON THE PHENYTOIN AND PHENOBARBITAL CONCENTRATIONS IN THE BRAIN CORTEX OF EPILEPTIC PATIENTS

Postmortem concentrations of phenytoin (PHT) and phenobarbital (PB) we re determined in 24 specimens of the frontal, temporal, occipital or n eocerebellar cortex with different pathological changes and in the ser um (total and free) from 11 epileptic patients. The cortical lesions w ere characterized by various degrees of neuronal loss or necrosis asso ciated with other changes such as proliferated gliocytes, fibre gliosi s, Rosenthal fibres or numerous corpora amylacea. According to other i nvestigators neurons are the main binding sites of PHT and PB in roden t brains. The PHT and PB concentrations in 20 cortical lesions from ni ne patients were not significantly reduced as compared to the data of 46 deceased epileptic control patients. A significantly decreased PB v alue could only be demonstrated in the temporal specimen of an old sca rred infarction with complete demyelination. On the other hand a sligh t but significant increase of PB was observed in three neocortical sam ples from a child exhibiting severe brain oedema and thrombosis of the sinuses. The results favour the unspecific binding of PHT and PB to c erebral tissue constituents and do not Support the hypothesis of major binding to specific receptors.