Lack of efficacy of levetiracetam in oromandibular and cranial dystonia

Park, J. E.; Srivanitchapoom, Prachaya; Maurer, Carine W.; Mathew, Pawan; Sackett, Jonathan; Paine, Rainer W.; Ramos, Vera; Hallett, Mark

doi:10.1111/ane.12701

Cited by 11 publications

(7 citation statements)

References 11 publications

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“…Some case reports found that zolpidem is effective in such patients as it is highly specific for a GABA omega-1 receptor (109,110). However, some studies found limited efficacy of oral medications such as zolpidem, levetiracetam, and valproate (111,112). A randomized controlled trial concluded that Levetiracetam does not appear to be efficacious in patients with OMD or cranial dystonia (111).…”

Section: Oral Medicationsmentioning

confidence: 99%

“…However, some studies found limited efficacy of oral medications such as zolpidem, levetiracetam, and valproate (111,112). A randomized controlled trial concluded that Levetiracetam does not appear to be efficacious in patients with OMD or cranial dystonia (111). A single-center, double-blind crosssectional study revealed that valproate had low efficacy in the treatment of MS (112).…”

Section: Oral Medicationsmentioning

confidence: 99%

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Blepharospasm, Oromandibular Dystonia, and Meige Syndrome: Clinical and Genetic Update

Liang-jun

et al. 2021

Front. Neurol.

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Meige syndrome (MS) is cranial dystonia characterized by the combination of upper and lower cranial involvement and including binocular eyelid spasms (blepharospasm; BSP) and involuntary movements of the jaw muscles (oromandibular dystonia; OMD). The etiology and pathogenesis of this disorder of the extrapyramidal system are not well-understood. Neurologic and ophthalmic examinations often reveal no abnormalities, making diagnosis difficult and often resulting in misdiagnosis. A small proportion of patients have a family history of the disease, but to date no causative genes have been identified to date and no cure is available, although botulinum toxin A therapy effectively mitigates the symptoms and deep brain stimulation is gaining increasing attention as a viable alternative treatment option. Here we review the history and progress of research on MS, BSP, and OMD, as well as the etiology, pathology, diagnosis, and treatment.

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Section: Oral Medicationsmentioning

confidence: 99%

Section: Oral Medicationsmentioning

confidence: 99%

Blepharospasm, Oromandibular Dystonia, and Meige Syndrome: Clinical and Genetic Update

Liang-jun

et al. 2021

Front. Neurol.

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“…Following reports of benefit in an open-label study in cervical dystonia, mexiletine, an oral antiarrhythmic drug derivative of lidocaine, was found to be effective in a small controlled trial of 8 patients in 2000 [96], but no further studies have been performed since. More recent developments in the pharmacologic management of dystonia include disappointing results of levetiracetam in oromandibular and cranial dystonia in a small controlled study [97]. However, zonisamide proved to be tolerable and efficacious for the motor symptoms of myoclonus-dystonia in a randomized double-blind placebo-controlled crossover trial with 24 patients [98].…”

Section: Other Medications and New Developmentsmentioning

confidence: 99%

Treatment of Dystonia: Medications, Neurotoxins, Neuromodulation, and Rehabilitation

2020

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Dystonia is a complex disorder with numerous presentations occurring in isolation or in combination with other neurologic symptoms. Its treatment has been significantly improved with the advent of botulinum toxin and deep brain stimulation in recent years, though additional investigation is needed to further refine these interventions. Medications are of critical importance in forms of dopa-responsive dystonia but can be beneficial in other forms of dystonia as well. Many different rehabilitative paradigms have been studied with variable benefit. There is growing interest in noninvasive stimulation as a potential treatment, but with limited long-term benefit shown to date, and additional research is needed. This article reviews existing evidence for treatments from each of these categories. To date, there are many examples of incomplete response to available treatments, and improved therapies are needed.

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“…Riluzole, a glutamate antagonist, showed benefit in a small series of patients with CD [ 29 ]. Levetiracetam was not shown to be helpful in a small series of patients with OMD or cranial dystonia [ 30 ].…”

Section: Dystoniamentioning

confidence: 99%

Treatment of dystonia and tics

Bellows

Jankovic

2020

Clinical Parkinsonism & Related Disorders

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Treatment of dystonia and tics continues to evolve. In dystonia, while oral agents such as benzodiazepines, baclofen and anticholinergics remain in use, botulinum toxin (BoNT) continues to be regarded as the treatment of choice for focal and segmental dystonia, but new preparations are being studied. While deep brain stimulation (DBS) has typically focused on targeting the globus pallidus internus (GPi) when treating dystonia, more recent research has expanded the targets to include subthalamic nucleus (STN) and other targets. In addition to DBS, thalamotomies continue to show therapeutic benefit in focal hand dystonias. Treatment of tics includes a growing armamentarium of options besides the three FDA-approved drugs, all dopamine receptor blockers (haloperidol, pimozide and aripiprazole). Because of lower risk of adverse effects, dopamine depleters (e.g. tetrabebazine, deutetrabenazine, and valbenazine), along with novel D1 receptor antagonists, are currently studied as treatment alternatives in patients with tics. Practice guidelines for the treatment of tics and Tourette syndrome have been recently updated. Data regarding the use of DBS in treatment of tics remains relatively sparse, but international registries have expanded our understanding of the effect of stimulation at several targets.

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Lack of efficacy of levetiracetam in oromandibular and cranial dystonia

Abstract: Levetiracetam does not appear to be efficacious in patients with oromandibular or cranial dystonia.

Cited by 11 publications

References 11 publications

Blepharospasm, Oromandibular Dystonia, and Meige Syndrome: Clinical and Genetic Update

Blepharospasm, Oromandibular Dystonia, and Meige Syndrome: Clinical and Genetic Update

Treatment of Dystonia: Medications, Neurotoxins, Neuromodulation, and Rehabilitation

Treatment of dystonia and tics

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