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Yıl:1996; Cilt: 1; Sayı: 2>> Özet
Nöropsikiyatri Gündemi; 1996;1(2):62-65
Miyotonia Konjenita Tedavisinde İkinci Jenerasyon Bir Antihistaminik (Astemizol)
Ş Öztürk, T Duman, S Gürçay
Ankara Numune Hastanesi Nöroloji Kliniği
Miyotonia konjenita, kaslarda istemli kasılmadan sonra gevşeme periyodunda gecikme ile karakterize, ağrısız, ekzersizle düzelme gösteren heterojen bir grup hastalıktır. Miyotoninin altta yatan mekanizması, kas kontraksiyonunu izleyen tekrarlayıcı membran aktivasyonudur. Miyotonia konjenitada kas membran direnci artmıştır. Miyotoni tedavisinde, membran repolarizasyon hızını etkileyen ve membran stabilitesini artıran ilaçların kullanımı temel alınmıştır. Başlangıçta kullanılan ajanlar kinin ve kinidindir. Ancak bu ilaçların, kullanımı sınırlayıcı yan etkileri vardır. Bugüne kadar prokainamid, fenitoin, tokainid, verapamil, nifedipin, lityum ve imipramin değişik oranda başarı ve toleransla kullanılmışlardır. Klinik gözleme dayanan bir çalışmada miyotonia konjenitalı bir ailede antihistaminik kullanımı ile miyotonik semptomların gerilediği belirtilmiştir. Bu çalışmada, otozomal dominant miyotonia konjenitalı bir aileden 6 hastanın antihistaminik ile tedavisini değerlendirdik. Çalışma için uzun etkili, nonsedatif, her yaş grubuna kullanılabilen, ikinci jenerasyon Hı histamin reseptör antagonisti astemizol seçildi. Hastalara 10 gün 5-10 mg astemizole günde tek doz olarak verildi. Tedavi süresince yan etki gözlenmedi. Tedavi öncesi ve sonrası değerler karşılaştırıldı. Uzun etkili olması ve bilinen yan etkilerinin azlığı nedeniyle astemizol, miyotoni tedavisinde bir seçenek olarak düşünüldü.

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