Parkinsonism due to lamotrigine

Santens, Patrick; Claeys, Isabel; Vonck, Kristl; Boon, Paul

doi:10.1002/mds.21125

Cited by 10 publications

(5 citation statements)

References 9 publications

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“…Chorea has been reported in patients treated with the combination of lamotrigine and phenytoin [96] but also with lamotrigine alone [97], and also in patients without epilepsy (bipolar disorder) [98]. Reversible parkinsonism secondary to lamotrigine use has been reported in the absence of presynaptic nigrostriatal involvement [99]. In patients with PD receiving dopaminergic treatment, adding lamotrigine has been associated with the onset of dyskinesias [100].…”

Section: Lamotriginementioning

confidence: 99%

Antiseizure Drugs and Movement Disorders

Sáenz‐Farret

Tijssen

Eliashiv³

et al. 2022

CNS Drugs

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The relationship between antiseizure drugs and movement disorders is complex and not adequately reviewed so far. Antiseizure drugs as a treatment for tremor and other entities such as myoclonus and restless leg syndrome is the most common scenario, although the scientific evidence supporting their use is variable. However, antiseizure drugs also represent a potential cause of iatrogenic movement disorders, with parkinsonism and tremor the most common disorders. Many other antiseizure drug-induced movement disorders are possible and not always correctly identified. This review was conducted by searching for all the possible combinations between 15 movement disorders (excluding ataxia) and 24 antiseizure drugs. The main objective was to describe the movement disorders treated and worsened or induced by antiseizure drugs. We also summarized the proposed mechanisms and risk factors involved in the complex interaction between antiseizure drugs and movement disorders. Antiseizure drugs mainly used to treat movement disorders are clonazepam, gabapentin, lacosamide, levetiracetam, oxcarbazepine, perampanel, phenobarbital, pregabalin, primidone, topiramate, and zonisamide. Antiseizure drugs that worsen or induce movement disorders are cenobamate, ethosuximide, felbamate, lamotrigine, phenytoin, tiagabine, and vigabatrin. Antiseizure drugs with a variable effect on movement disorders are carbamazepine and valproate while no effect on movement disorders has been reported for brivaracetam, eslicarbazepine, lacosamide, and stiripentol. Although little information is available on the adverse effects or benefits on movement disorders of newer antiseizure drugs (such as brivaracetam, cenobamate, eslicarbazepine, lacosamide, and rufinamide), the evidence collected in this review should guide the choice of antiseizure drugs in patients with concomitant epilepsy and movement disorders. Finally, these notions can lead to a better understanding of the mechanisms involved in the pathophysiology and treatments of movement disorders.

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Section: Lamotriginementioning

confidence: 99%

Antiseizure Drugs and Movement Disorders

Sáenz‐Farret

Tijssen

Eliashiv³

et al. 2022

CNS Drugs

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Section: Resultsmentioning

confidence: 99%

“…Bilateral subthalamic stimulation was reported to improve parkinsonism in four patients with MSA-P, with the main benefits observed for rigidity and parkinsonism. 46 However, other authors have reported deleterious effects of deep brain stimulation. [46][47][48][49][50][51][52] At present, surgical therapy is not considered an effective therapeutic tool in the routine management of patients with MSA.…”

Section: Therapymentioning

confidence: 99%

Tremor in Multiple System Atrophy – a review

Kaindlstorfer

Granata

Wenning

2013

Tremor and Other Hyperkinetic Movements

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Background: Multiple system atrophy (MSA) is a rare neurodegenerative movement disorder characterized by a rapidly progressive course. The clinical presentation can include autonomic failure, parkinsonism, and cerebellar signs. Differentiation from Parkinson's disease (PD) is difficult if there is levodoparesponsive parkinsonism, rest tremor, lack of cerebellar ataxia, or mild/delayed autonomic failure. Little is known about tremor prevalence and features in MSA. Methods: We performed a PubMed search to collect the literature on tremor in MSA and considered reports published between 1900 and 2013. Results: Tremor is a common feature among MSA patients. Up to 80% of MSA patients show tremor, and patients with the parkinsonian variant of MSA are more commonly affected. Postural tremor has been documented in about half of the MSA population and is frequently referred to as jerky postural tremor with evidence of minipolymyoclonus on neurophysiological examination. Resting tremor has been reported in about one-third of patients but, in contrast to PD, only 10% show typical parkinsonian ''pill-rolling'' rest tremor. Some patients exhibit intention tremor associated with cerebellar dysmetria. In general, MSA patients can have more than one tremor type owing to a complex neuropathology that includes both the basal ganglia and pontocerebellar circuits. Discussion: Tremor is not rare in MSA and might be underrecognized. Rest, postural, action and intention tremor can all be present, with jerky tremulous movements of the outstretched hands being the most characteristic. However, reviewing the data on tremor in MSA suggests that not every shaky movement satisfies tremor criteria; therefore, further studies are needed.

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“…Finally, a drug effect might be another alternative explanation for group differences in the present study. Valproate may cause Parkinsonism in 1% to 5%, and there are also reports of lamotrigine being responsible for Parkinsonism, possibly due to an inhibition of dopamine turnover (Ristic et al, 2006; Santens et al, 2006; Jamora et al, 2007). Drug effects, however, would not explain the selective changes in the posterior putamen.…”

Section: Discussionmentioning

confidence: 99%

Alteration of dopamine D2/D3 receptor binding in patients with juvenile myoclonic epilepsy

Landvogt¹,

Buchholz²,

Bernedo

et al. 2010

Epilepsia

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SUMMARYPurpose: To quantify extrastriatal and striatal D2/D3 receptor binding in patients with juvenile myoclonic epilepsy (JME) using the high-affinity dopamine D2/D3 receptor positron emission tomography (PET) ligand 18 F-Fallypride ([ 18 F]FP). Methods: Twelve patients with JME and 21 age-matched control subjects were studied. Dynamic images (180 min) were acquired after injection of [18 F]FP. Patients had been seizure-free of all seizure types for at least 10 days before scanning. Parametric images of binding potential (BP) were created using the simplified reference tissue model. The images were stereotactically normalized using a ligand-specific template. We performed a voxelbased analysis with statistical parametric mapping (SPM2). Region of interest (ROI) analysis was done comparing the BP of the thalamus, caudate nucleus, anterior (ventral) and posterior (dorsal) putamen, ventral striatum, and temporal lobe.Results: Compared to controls, patients with JME showed a significant decrease in [18 F]FP BP (SPM analysis corr. p < 0.001 at cluster level) restricted to the bilateral posterior putamen. There was no significant alteration of [18 F]FP binding in other brains regions. ROI analysis revealed a significant (p < 0.05) decrease of [ 18 F]FP BP in the left (mean )14.8%) and right (mean )16.9%) posterior putamen, but not in the anterior putamen, caudate, ventral striatum, thalamus, or temporal lobe. Discussion: Patients with JME showed a reduction in D2/3 receptor binding restricted to the bilateral posterior putamen, suggesting a specific alteration of the dopaminergic system. Whether these changes can be regarded as merely functional or whether they relate to the pathophysiology of juvenile myoclonic epilepsy still remains unclear.

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Parkinsonism due to lamotrigine

Cited by 10 publications

References 9 publications

Antiseizure Drugs and Movement Disorders

Antiseizure Drugs and Movement Disorders

Tremor in Multiple System Atrophy – a review

Alteration of dopamine D2/D3 receptor binding in patients with juvenile myoclonic epilepsy

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