Levetiracetam in patients with generalised epilepsy and myoclonic seizures: An open label study

Labate, Angelo; Colosimo, Eleonora; Gambardella, Antonio; Leggio, Ugo; Ambrosio, Roberta; Quattrone, Aldo

doi:10.1016/j.seizure.2005.12.004

Cited by 67 publications

(53 citation statements)

References 10 publications

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“…23,24 Our study evaluated both the efficacy and the safety of LEV in the treatment of JME and our results reinforce the concept that LEV works very well in the treatment of JME. A very recent study 15 showed a good response in 35 patients with different types of epilepsy (but all characterized by prominent myoclonic seizures). In fact, myoclonus responded dramatically to LEV and a total of 29 patients obtained seizure reduction.…”

Section: Discussionmentioning

confidence: 98%

Levetiracetam in juvenile myoclonic epilepsy: long‐term efficacy in newly diagnosed adolescents

Verrotti

Cerminara

Coppola

et al. 2007

Develop Med Child Neuro

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The aim of this study was to evaluate the efficacy and tolerability of levetiracetam (LEV) monotherapy in juvenile myoclonic epilepsy (JME). The study group consisted of 32 patients with epilepsy (20 males, 12 females) with a mean age of 13 years 3 months (SD 7y 11mo) at seizure onset. LEV was administered as the first drug; all patients were followed up at 6 and 12 months. The dose that achieved seizure control ranged from 1000 to 2500mg/daily. At 6-month evaluation: 15 patients were seizure free; 14 patients were responders (>50% reduction in seizures); and three patients had marginal effects (<50% reduction of seizures). At 12-month evaluation: 29 patients were seizure free; three patients were responders. No patients reported adverse events. These data provide preliminary evidence that LEV may be effective for treating patients with newly diagnosed JME.Juvenile myoclonic epilepsy (JME) is an idiopathic generalized epilepsy, characterized by irregular myoclonic jerks, tonicclonic seizures, and sometimes typical absences. 1 The main clinical symptoms of JME are myoclonic jerks on awakening, generalized tonic-clonic seizures, typical absences, and photosensitivity. 1,2 This type of epilepsy generally responds to antiepileptic drugs (AEDs) and is, therefore, generally considered a benign type of epilepsy. 3 Physicians have at their disposal many AEDs to treat JME; historically, valproic acid was the first AED used to treat myoclonic seizures, 4 but levetiracetam (LEV) could be a good alternative because of its efficacy against all three JME seizure types and photosensitivity, and because of lack of the endocrine and metabolic side-effects frequently reported in patients receiving valproic acid. 5,6 LEV is a novel AED because its mechanisms of action appear different from other AEDs and seem to be unrelated to known mechanisms of neurotransmission. In fact, it has no significant affinity for gamma-aminobutyric acidergic or glutamatergic receptors and does not interact directly with the benzodiazepine binding site. 7 LEV seems to partially inhibit N-type high voltage-activated Ca 2+ currents and reduces Ca 2+ release from intraneuronal stores; it reverses the effects of negative allosteric modulators of gamma aminobutyric acid and glycine-gated currents. [8][9][10] Recently, the LEV binding site was identified as synaptic vesicle protein 2A (SV2A). 11 A very recent study 12 has explored the hypothesis that the antiepileptic mechanism of action of LEV is related to effects on alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) receptor channels in mouse cortical neurons. This study reveals that AMPA receptors are modulated by LEV because a significant decrease was found in the kainate and AMPA-induced miniature excitatory postsynaptic currents in cortical neurons.Several reports and open label studies have pointed out the efficacy of LEV in generalized epilepsy. [13][14][15][16] Moreover, LEV has been shown to be effective in preventing the photoparoxysmal response in patients with photosensitive epile...

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Section: Discussionmentioning

confidence: 98%

Levetiracetam in juvenile myoclonic epilepsy: long‐term efficacy in newly diagnosed adolescents

Verrotti

Cerminara

Coppola

et al. 2007

Develop Med Child Neuro

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“…Open-label trials in children have demonstrated good efficacy and tolerability in refractory mixed seizure disorders (19,20) Efficacy in primary generalized epilepsy, such as juvenile myoclonic epilepsy, has also been established; however, rarely, myoclonic seizure may be worsened by this drug (21,22). Levetiracetam is excreted primarily by the kidneys with minimal hepatic metabolism.…”

Section: Levetiracetammentioning

confidence: 99%

New generation anticonvulsants for the treatment of epilepsy in children

Donner

Snead

2006

Neurotherapeutics

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Over the past 12 years, a number of new anticonvulsant drugs have been introduced for the treatment of childhood epilepsy. The present article reviews these new agents and provides the considerations one should use in selecting an antiepileptic drug for use in children. While in some cases the newer antiepileptic drugs have a more favourable pharmacokinetic and toxicity profile than the older drugs, there appears to be no objective evidence that any currently available antiepileptic drug is superior in terms of therapeutic efficacy.

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“…women, and it is characterized by frequent bilateral myoclonic jerks of the arms associated at times with generalized tonic-clonic or absence seizures with a good response to antiepileptic drugs [3][4][5]. Habitually, menstrual period and sleep deprivation can trigger seizures.…”

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confidence: 99%

“…Habitually, menstrual period and sleep deprivation can trigger seizures. Seizures are very well controlled by appropriate therapy in up to 90% of subjects [3,4]. Generalized 3-6 Hz polyspike-wave (PSW) discharges are the cornerstone in the diagnosis and treatment of JME [3][4][5].…”

mentioning

confidence: 99%

“…Seizures are very well controlled by appropriate therapy in up to 90% of subjects [3,4]. Generalized 3-6 Hz polyspike-wave (PSW) discharges are the cornerstone in the diagnosis and treatment of JME [3][4][5]. According to the International Classification of Headache Disorders II (ICHD-II), the diagnosis of ''migralepsy'' should fulfil two diagnostic criteria: migraine fulfilling criteria for migraine with aura (MA) and a seizure fulfilling diagnostic criteria for one type of epileptic attack occurs during or within one hour after a migraine aura [6].…”

mentioning

confidence: 99%

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Migraine attack triggering a generalised seizure: is this a case of migralepsy or ictal epileptic headache?

et al. 2011

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Levetiracetam in patients with generalised epilepsy and myoclonic seizures: An open label study

Abstract: Our results confirm that LEV as de novo (monotherapy) and add-on therapy at doses between 2000 and 3000 mg/day effectively reduces myoclonic seizure frequency in patients with generalised epilepsy. LEV was also well-tolerated.

Cited by 67 publications

References 10 publications

Levetiracetam in juvenile myoclonic epilepsy: long‐term efficacy in newly diagnosed adolescents

Levetiracetam in juvenile myoclonic epilepsy: long‐term efficacy in newly diagnosed adolescents

New generation anticonvulsants for the treatment of epilepsy in children

Migraine attack triggering a generalised seizure: is this a case of migralepsy or ictal epileptic headache?

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