Levetiracetam Control of Myoclonus in a Patient with Creutzfeldt-Jakob Disease

Imperiale, Daniele; Bortolotto, Simona; Cucatto, A; Schiffer, Paola; Cassano, Daniela; Buffa, Carlo

doi:10.1159/000069083

Cited by 7 publications

(4 citation statements)

References 4 publications

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“…There was also 1 single case report of dramatic improvement in 1 patient with MERRF (Mancuso et al 2006), and a report of LEV benefit in 2 sisters with Lafora body disease (Boccella et al 2003). Of note is that there have been several reports of LEV in non-epileptic myoclonus, with variable success (Frucht et al 2001; Genton and Gelisse 2001; Krauss et al 2001; Keswani et al 2002; Schauer et al 2002; Imperiale et al 2003; Lim and Ahmed 2005; Striano et al 2005). …”

Section: Levetiracetammentioning

confidence: 99%

Levetiracetam in the treatment of epilepsy

Abou‐Khalil

2008

NDT

204

136

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Epilepsy is a common chronic disorder that requires long-term antiepileptic drug therapy. Approximately one half of patients fail the initial antiepileptic drug and about 35% are refractory to medical therapy, highlighting the continued need for more effective and better tolerated drugs. Levetiracetam is an antiepileptic drug marketed since 2000. Its novel mechanism of action is modulation of synaptic neurotransmitter release through binding to the synaptic vesicle protein SV2A in the brain. Its pharmacokinetic advantages include rapid and almost complete absorption, minimal insignifi cant binding to plasma protein, absence of enzyme induction, absence of interactions with other drugs, and partial metabolism outside the liver. The availability of an intravenous preparation is yet another advantage. It has been demonstrated effective as adjunctive therapy for refractory partial-onset seizures, primary generalized tonic-clonic seizures, and myoclonic seizures of juvenile myoclonic epilepsy. In addition, it was found equivalent to controlled release carbamazepine as fi rst-line therapy for partial-onset seizures, both in effi cacy and tolerability. Its main adverse effects in randomized adjunctive trials in adults have been somnolence, asthenia, infection, and dizziness. In children, the behavioral adverse effects of hostility and nervousness were also noted. Levetiracetam is an important addition to the treatment of epilepsy.

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Section: Levetiracetammentioning

confidence: 99%

Levetiracetam in the treatment of epilepsy

Abou‐Khalil

2008

NDT

204

136

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“…In another case of probable sCJD, myoclonus and seizures were not amenable to valproic acid 2000 mg/day, clonazepam 1 mg/day, or phenobarbital 100 mg/day [38]. Improvement in symptoms was only achieved with levetiracetam (LEV) 1000 – 3000 mg/day, with the return of symptoms when the medication was briefly stopped.…”

Section: Human Prion Diseasesmentioning

confidence: 99%

Rapidly progressive dementias and the treatment of human prion diseases

Appleby

2010

Expert Opinion on Pharmacotherapy

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Importance of the field Rapidly progressive dementia (RPD) has many possible etiologies and definitive treatment is reliant upon an accurate diagnosis from an appropriate diagnostic work-up. A large portion of the neurodegenerative causes of RPD are due to prion diseases (e.g., Creutzfeldt–Jakob disease). The study of prion diseases, for which there is no currently available treatment, has public health implications and is becoming increasingly more relevant to our understanding of other protein misfolding disorders including Alzheimer’s disease, frontotemporal degeneration, and Parkinson’s disease. Areas covered in this review This article begins with an overview of the etiologies and diagnostic work-up of RPD followed by a detailed review of the literature concerning the treatment of human prion diseases (1971 to present). What the reader will gain The reader will understand the differential diagnosis and work-up of RPD as it pertains to its treatment, as well as an in-depth understanding of treatments of human prion diseases. Take home message An accurate diagnosis of the cause of RPD is of paramount importance when determining appropriate treatment. Most studies of the treatment for human prion diseases are case reports or case series, and results from only one randomized, placebo-controlled study have been reported in the literature (flupirtine). Studies have been hindered by disease heterogeneity and lack of standardized outcome measures. Although no effective prion disease treatment has been revealed through these studies, they provide important considerations for future studies.

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“…Another symptom that occurs early in the disease process is myoclonus, an involuntary twitching of the muscles that can be severe and distressing to both the patient and family members. Levetiracetam is a relatively new anti-epileptic drug used to control partial seizures and it has proved to markedly decrease myoclonis in CJD patients (14).…”

Section: Management Of Cjdmentioning

confidence: 99%

Creutzfeldt-Jakob Disease: A Review of Current Available Evidence and the Implications for Prehospital Emergency Care

Kirby

2016

Australasian Journal of Paramedicine

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Introduction: Creutzfeldt-Jakob Disease effects 1 in 1 million people globally per year. It is an invariable fatal neurodegenerative disease belonging to the group of transmissible spongiform encephalopathies. This review aims to examine the current clinical evidence surrounding CJD, as well as present management techniques to assist in minimizing the effect of symptoms. This review also highlights the important role of paramedics in reducing mortality and morbidity.Methods: An electronic search was conducted using Medline (Via EBSCOHost), CINAHL, and the Cochrane Database of Systematic Reviews. Results: This search resulted in 265 articles. Articles unavailable as full text, those not available in English, those articles not peer reviewed, and review articles were all excluded from analysis. The remaining 16 articles met the search criteria and were included in this report.Conclusion: Scientific advancements are bringing a cure closer to reality, however further scientific research needs to be conducted. Training and education programs should be made available to prehospital workers to prevent further spread of infection.

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Levetiracetam Control of Myoclonus in a Patient with Creutzfeldt-Jakob Disease

Cited by 7 publications

References 4 publications

Levetiracetam in the treatment of epilepsy

Levetiracetam in the treatment of epilepsy

Rapidly progressive dementias and the treatment of human prion diseases

Creutzfeldt-Jakob Disease: A Review of Current Available Evidence and the Implications for Prehospital Emergency Care

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