RELATIONSHIP BETWEEN ISCHEMIC DAMAGE AND CONCENTRATIONS OF PHENYTOIN AND PHENOBARBITAL IN THE BRAIN CORTEX OF EPILEPTIC PATIENTS IN VEGETATIVE STATE AT DEATH

Post-mortem concentrations of phenytoin (PHT) and phenobarbital (PB) w ere determined by high-performance liquid chromatography in the cortic al matter of specified brain regions and in the serum (total and free) from 3 epileptic males in vegetative state and compared to the data o f 45 deceased epileptic control patients. The duration of the vegetati ve state was 12 days, 15 days or about 4 months until death and was as sociated with corresponding stages of generalized ischemic brain damag e. The histological examination was completed by immunohistochemical a nd morphometric methods. According to other investigators nerve cells are the major binding sites for PHT and PB in the cerebral cortex of r odents. But, in the 3 comatose patients the PHT and PB concentrations of the isocortex and neocerebellum were not significantly decreased in comparison with the control patients despite necrosis and loss of neu rons as well as other distinct tissue alterations. The results strongl y favor the non-specific binding of PHT and PB to cells and subcellula r structures of the brain - mainly based on simple physico-chemical pr inciples.