Levetiracetam for the treatment of idiopathic generalized epilepsy with myoclonic seizures

Noachtar, S.; Andermann, Eva; Meyvisch, Paul; Andermann, Frédérick; Gough, William B.; Schiemann-Delgado, Jimmy

doi:10.1212/01.wnl.0000297512.18364.40

Cited by 217 publications

(159 citation statements)

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“…Epileptiform EEG asymmetries in juvenile myoclonic epilepsy are frequent and various rates are reported in the literature: 16.5% 4,6 , 38.1% 12 and 72.7% 8 . In our study, more than half the patients, namely 57.1%, had EEG asymmetric features.…”

Section: Discussionmentioning

confidence: 99%

“…Myoclonic seizures occur often shortly after awakening and can be precipitated by sleep deprivation and also by alcohol and photic stimulation. Usually, patients with JME respond well to appropriate treatment with valproate 3,4 . Other useful anti-epileptic drugs (AEDs) also used with other generalized epilepsies include: lamotrigine, levetiracetam and topiramate 5 .…”

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confidence: 99%

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Epileptiform Asymetries and Treatment Response in Juvenile Myoclonic Epilepsy

Létourneau

Cieuta‐Walti

Deacon

2010

Can. j. neurol. sci.

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Juvenile myoclonic epilepsy (JME) is a common idiopathic generalized and age-related epileptic syndrome. This syndrome is distinctively characterized by myoclonic jerks often associated with generalized tonic-clonic seizures (GTCS) and, less often, absence seizures 1,2 . Myoclonic seizures occur often shortly after awakening and can be precipitated by sleep deprivation and also by alcohol and photic stimulation. Usually, patients with JME respond well to appropriate treatment with valproate 3,4 . Other useful anti-epileptic drugs (AEDs) also used with other generalized epilepsies include: lamotrigine, levetiracetam and topiramate 5 .The interictal electroencephalogram (EEG) shows diffuse bilateral polyspike and slow waves (PSW) and spike and wave complexes (SWC) on a normal background 2 . The usual ABSTRACT: Background: Epileptiform electroencephalogram (EEG) asymmetries are not uncommon in juvenile myoclonic epilepsy (JME) and can contribute to the misdiagnosis of this syndrome. The objective of this study is to further characterize patients with focal or asymmetric epileptiform electroencephalographic abnormalities and more specifically in terms of response to treatment. Controversial data exists in the literature concerning this issue. Methods: We retrospectively reviewed clinical and EEG data of a group of consecutive JME patients followed at our Epilepsy Service. The first EEG available for each patient was reviewed blindly by two independent electroencephalographers. Results: Twenty-eight patients with JME were identified: 11 (39.3%) were resistant to at least one appropriate anti-epileptic drug (AED), including valproate, lamotrigine, topiramate or levetiracetam. All patients except two had generalized epileptiform abnormalities. Overall, EEG asymmetries were detected in 57.1% of the cases. The proportion of EEG asymmetries between AED-sensitive group (52.9%) and AED-resistant group (63.5%) did not reach statistical significance. Concordance between examiners for identification of EEG asymmetries was good. Analysis of patients with and without asymmetries showed no statistically significant differences in comparisons of age, family history of seizure, presence of polyspike and slow wave, photosensitivity and timing of EEG related to the onset of treatment. Conclusion: Asymmetric electroencephalographic abnormalities are frequent in patients with JME. These features should not be misinterpreted as being indicative of partial epilepsy. In our group, asymmetries were not associated with resistance to treatment.RÉSUMÉ: Asymétries épileptiformes et réponse au traitement dans l'épilepsie myoclonique juvénile. Contexte : Les asymétries épileptiformes à l'EEG sont fréquentes dans l'épilepsie myoclonique juvénile (EMJ) et peuvent contribuer à un diagnostic erroné de ce syndrome. Le but de cette étude était de mieux caractériser les patients qui ont des anomalies focales ou des anomalies asymétriques épileptiformes à l'EEG, plus particulièrement en ce qui concerne la réponse au traitement. Il existe dans la littéra...

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Epileptiform Asymetries and Treatment Response in Juvenile Myoclonic Epilepsy

Létourneau

Cieuta‐Walti

Deacon

2010

Can. j. neurol. sci.

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“…Очередность выбора препарата при юношеской мио-клонической эпилепсии: первая линия -леветирацетам, вальпроат, топирамат, ламотриджин; препараты второй линии -леветирацетам, вальпроат, топирамат, ламо-триджин; препараты третьей линии -клобазам*, клона-зепам, зонисамид* [53]. По данным [47,48,54] о примене-нии леветирацетама в лечении юношеской миоклониче-ской эпилепсии однозначно свидетельствует о высокой его эффективности. Эффективность применения препа-рата доказана в добавочной терапии больных юношеской миоклонической эпилепсии в исследовании первого класса доказательности, уровень А [54].…”

Section: эпилепсия у детейunclassified

“…По данным [47,48,54] о примене-нии леветирацетама в лечении юношеской миоклониче-ской эпилепсии однозначно свидетельствует о высокой его эффективности. Эффективность применения препа-рата доказана в добавочной терапии больных юношеской миоклонической эпилепсии в исследовании первого класса доказательности, уровень А [54]. В одном из двой-ных слепых плацебо-контролируемых исследований [47] была установлена высокая эффективность ламотриджина и леветирацетама в дополнительной терапии при этой форме эпилепсии.…”

Section: эпилепсия у детейunclassified

“…Наличие раствора для приема внутрь -очень большой плюс, принципиально отличающий кеппру от других ПЭП и дженериков левети-рацетама [47,54,56,57]. Имеющиеся в настоящее время данные о применении леветирацетама позволяют реко-мендовать его также для стартовой монотерапии юноше-ской миоклонической эпилепсии у женщин [53,58].…”

Section: эпилепсия у детейunclassified

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