- |||||||||| lacosamide / Generic mfg., levetiracetam / Generic mfg., methylprednisolone sodium succinate / Generic mfg.
Refractory Seizures in the Setting of Lupus (Both in-person and online) - Mar 12, 2023 - Abstract #AAN2023AAN_3222;
Lacosamide and valproic acid were added with some improvement...The patient was started on plasmapheresis concurrently with a 5-day course of IV methylprednisolone with steroid taper...Conclusions Antibody-mediated diseases can occur anywhere in the body where the immune system is able to gain access to a target antigen. We believe that CNS involvement of lupus may represent an under-recognized entity in the general category of NPSLE with features of autoimmune encephalitis, which include a similar therapeutic response to early plasmapheresis.
- |||||||||| methotrexate / Generic mfg., levetiracetam / Generic mfg.
No Rheum at The Insula: Rheumatoid Lepto-meningitis as Cause of Focal Seizure (Both in-person and online) - Mar 12, 2023 - Abstract #AAN2023AAN_3219;
Conclusions Rheumatoid arthritis is a known systemic disease that can potentially and rarely affect other organs including the CNS. In this case, the patient presented with focal seizures secondary to cortical irritation caused by leptomeningeal enhancements of her right hemisphere.
- |||||||||| levetiracetam / Generic mfg.
Seizures in Neurosarcoidosis (Both in-person and online) - Mar 12, 2023 - Abstract #AAN2023AAN_3207;
In this case, the patient presented with focal seizures secondary to cortical irritation caused by leptomeningeal enhancements of her right hemisphere. Most (18/26, 69.2%) required only 1 medicine for control with levetiracetam being beneficial in 22/22 (100%) trialed...Median follow-up of
- |||||||||| ketoconazole / Generic mfg., levetiracetam / Generic mfg., methylprednisolone sodium succinate / Generic mfg.
Cushing (Both in-person and online) - Mar 12, 2023 - Abstract #AAN2023AAN_3166;
Objective NA Design/Methods A male in his 50s presented with episodic word-finding difficulties, inappropriate smiling, fatigue, cognitive decline and one episode of generalized tonic clonic seizure on levetiracetam from an outside hospital...He was started on high-dose IV methylprednisolone followed by IVIg for presumed autoimmune encephalitis...The diagnosis was supported by elevated random and urine cortisol levels and managed with etomidate and ketoconazole...It can be an emergency requiring prompt endocrine and surgical evaluation. Serum cortisol levels should be checked in patients presenting with acute personality changes and seizures.
- |||||||||| Botox (onabotulinumtoxin A) / GSK, AbbVie, Healis Therap
Seronegative Isaac Syndrome Presenting as Focal Limb Stiffness Responsive to Plasma Exchange Therapy (Both in-person and online) - Mar 12, 2023 - Abstract #AAN2023AAN_2907;
Symptomatic management with diazepam, lorazepam, baclofen, mexiletine, and trihexyphenidyl was ineffective...She received partial benefit from carbamazepine, levetiracetam, cyclobenzaprine, and onabotulinumtoxinA injections, but symptoms remained debilitating...Conclusions We report a case of seronegative Isaac syndrome initially presenting with focal limb stiffness and dystonic posturing that was exquisitely responsive to plasmapheresis. This case highlights the need to consider peripheral nerve hyperexcitability syndromes in patients presenting with focal limb stiffness or painful dystonia and provides additional support for plasmapheresis as an effective treatment option for patients with debilitating symptoms.
- |||||||||| levetiracetam / Generic mfg.
High-Dose Levetiracetam: A Novel Post-Arrest Anti-Arrhythmic Medication? (Both in-person and online) - Mar 12, 2023 - Abstract #AAN2023AAN_2891;
This case highlights the need to consider peripheral nerve hyperexcitability syndromes in patients presenting with focal limb stiffness or painful dystonia and provides additional support for plasmapheresis as an effective treatment option for patients with debilitating symptoms. Design/Methods Case Description: A 17-month-old female presented in ventricular fibrillation arrest thought to be secondary to methamphetamine toxicity and a mitochondrial genetic mutation (discovered and confirmed later in her hospitalization)...Magnetic resonance imaging (MRI) on day 8 post-arrest was without evidence of diffusion restriction or T2-flair abnormalities and was thought to represent pseudonormalization in setting of hypoxic injury.
- |||||||||| levetiracetam / Generic mfg.
Anti-seizure Medication Use and Outcomes in Older Adults with Acute Traumatic Brain Injury (Both in-person and online) - Mar 12, 2023 - Abstract #AAN2023AAN_2888;
Levetiracetam was the only ASM prescribed...Conclusions ASMs were frequently continued for >7 days with no significant association with short-term outcomes. Larger comparative studies are indicated to determine both short and long-term risk-benefit trade-offs of ASM prophylaxis in older adults with TBI.
- |||||||||| acetazolamide / Generic mfg., levetiracetam / Generic mfg.
Pediatric opsoclonus myoclonus ataxia syndrome in the setting of COVID-19 (Both in-person and online) - Mar 12, 2023 - Abstract #AAN2023AAN_2198;
Prospective studies are necessary to confirm these findings and assess the impact on longitudinal functional outcomes. Both were treated with IVIG and high dose steroids.
- |||||||||| levetiracetam / Generic mfg.
Anti-NMDAR encephalitis mimicking rapidly progressive neurodegenerative disorder in a toddler: a case report (Both in-person and online) - Mar 12, 2023 - Abstract #AAN2023AAN_2133;
She was started on Keppra with resolution of her seizures...She was discharged on day 68 of hospitalization, with plan to continue intravenous immunoglobulin monthly. Conclusions Our case emphasizes the significance of suspecting anti-NMDAR encephalitis as a cause of progressive neurological deterioration in young children.
- |||||||||| levetiracetam / Generic mfg.
Is Thalamic DBS Synergistic With VNS in Drug Resistant Genetic Generalized Epilepsy? (Both in-person and online) - Mar 12, 2023 - Abstract #AAN2023AAN_2084;
Stable doses of Onfi 20 mg po bid and Keppra 1500 mg po bid were continued...Conclusions Identifying a subset of patients with GGE responsive to polyneuromodulation promises personalized therapy for those with life-altering effects from generalized seizures. We speculate that the thalamic network connectivity may be modulated by dual ANT-DBS and VNS, leading to targeted neurobiological therapy in some patients with GGE.
- |||||||||| levetiracetam / Generic mfg.
Posterior Reversible Encephalopathy Syndrome Causing Takotsubo Cardiomyopathy or Vise a Versa: How to Differentiate (Both in-person and online) - Mar 12, 2023 - Abstract #AAN2023AAN_1912;
Treatment with levetiracetam improved her encephalopathy, but hospitalization was complicated by cardiogenic shock requiring ionotropic support...Cardiac biomarkers and EKG should be obtained. If any cardiac markers abnormal thorough cardiologic work up should be performed however conversely patient with TC if patient has any neurologic clinical symptoms further neurological work up is warranted
- |||||||||| Xcopri (cenobamate) / SK Bio, Angelini Group, Endo
The Pharmacokinetics of Cenobamate When Used as Monotherapy (Both in-person and online) - Mar 12, 2023 - Abstract #AAN2023AAN_1890;
Therefore, plasma cenobamate exposures with adjunctive therapy were comparable to monotherapy. Conclusions Based on these findings, cenobamate monotherapy should result in plasma exposures comparable to those that have been demonstrated to be safe and effective when used as adjunctive therapy for the treatment of focal seizures.
- |||||||||| levetiracetam / Generic mfg.
A novel CACNA1A variant causing Developmental and Epileptic Encephalopathy 42: Report of the first case in Colombia (Both in-person and online) - Mar 12, 2023 - Abstract #AAN2023AAN_1713;
At 12 months, she presented to the Neurology and Genetics department with macrocephaly, frontal bossing, severe hypotonia, psychomotor delay, and repeated episodes of seizures requiring therapy with valproic acid and levetiracetam...Conclusions These findings widen the mutation and phenotypic spectrum of CACNA1A-associated disease. The potential genotype-phenotype correlation would facilitate early identification and help guide future pharmacologic treatment research.
- |||||||||| lacosamide / Generic mfg., levetiracetam / Generic mfg., methylprednisolone sodium succinate / Generic mfg.
S for Seizure? A Case of SMART syndrome (Both in-person and online) - Mar 12, 2023 - Abstract #AAN2023AAN_1708;
Due to ongoing seizures, he received 5 days of high dose intravenous methylprednisolone...He remains seizure-free 4 months later on levetiracetam and lacosamide...This exhibits a possible benefit of steroid treatment for seizure control in these patients. Further studies are warranted to delineate the pathophysiology and standardize the management of SMART syndrome.
- |||||||||| levetiracetam / Generic mfg.
Resident-Driven Quality Improvement Project to Improve Treatment of Status Epilepticus (Both in-person and online) - Mar 12, 2023 - Abstract #AAN2023AAN_1571;
Design/Methods We implemented the following interventions: 1) educate prescribers in the neurology, emergency medicine, and critical care departments regarding the approved institutional protocol for SE and availability of an orderset with optimal dosing, 2) two-factor communication regarding SE medication orders to nursing and education of nursing and pharmacy staff regarding target administration times, 3) add ready-to-mix levetiracetam to nurse omnicells on high-volume floors, and 4) update the SE orderset to improve usability across multiple departments...Conclusions Our resident-driven QI project led to improvement in dosing and timing of administration of BZ and second line ASMs. BZ dosing continues to be a major area for improvement.
- |||||||||| levetiracetam / Generic mfg.
Post-traumatic Seizures in Children with Abusive Head Trauma (Both in-person and online) - Mar 12, 2023 - Abstract #AAN2023AAN_1551;
Although levetiracetam was most commonly used, monotherapy with the same was ineffective in >50%...While most PTS were clinical and occurred early, cEEG monitoring was essential in detection and treatment of subclinical seizures. Overall, PTS had a good survival rate and outcomes.
- |||||||||| levetiracetam / Generic mfg.
Impact of a Free Anti-seizure Medication Intervention on Anxiety and Depression in People Living with Epilepsy in the Republic of Guinea (Both in-person and online) - Mar 12, 2023 - Abstract #AAN2023AAN_1530;
Average seizure frequency over the 30 days pre-enrollment was 3.2 (SD=5.9; 28% seizure-free during this period).Treatment regimens were modified for 95% of participants, mostly consisting of new levetiracetam provision (n=115)...Conclusions High levels of anxiety and depression occur in PLWE in Guinea, underscoring the unmet psychiatric needs in un- and under-treated epilepsy and the need for collaboration between neurologists and psychiatrists. Medication intervention may positively impact mental health, highlighting seizure control in addition to psychiatric intervention for this population.
- |||||||||| levetiracetam / Generic mfg.
Epileptic Amnesia as an Alzheimer (Both in-person and online) - Mar 12, 2023 - Abstract #AAN2023AAN_1417;
Results NA Conclusions Uncontrolled mesial temporal lobe epilepsy can result in hippocampal atrophy and cause amnestic problems. Epilepsy should be a diagnostic consideration in patients who present for evaluation of dementia.
- |||||||||| lorazepam / Generic mfg., levetiracetam / Generic mfg., midazolam hydrochloride / Generic mfg.
CHANTER Syndrome: A Rare Cause of Encephalopathy and Ischemic Lesions (Both in-person and online) - Mar 12, 2023 - Abstract #AAN2023AAN_1398;
Seizures of unclear duration were noted on ambulance arrival and midazolam was administered...Video EEGs showed severe diffuse slowing, generalized periodic discharges that became blunted with triphasic morphology after lorazepam and levetiracetam administration...However, the clinical recovery was very limited. Status epilepticus and transient hypotension may have played a role in the poor recovery.
- |||||||||| baclofen / Generic mfg., levetiracetam / Generic mfg.
Persistent Hiccups Following Thalamic Hemorrhage (Both in-person and online) - Mar 12, 2023 - Abstract #AAN2023AAN_1395;
He was then started on Baclofen 10 mg PO TID which resulted in a significant improvement in hiccups. Conclusions Our case suggests that thalamic lesions might also lead to persistent hiccups.
- |||||||||| levetiracetam / Generic mfg.
Visual hallucinations. More than just a psychiatric problem. (Both in-person and online) - Mar 12, 2023 - Abstract #AAN2023AAN_1292;
Conclusions Our case suggests that thalamic lesions might also lead to persistent hiccups. After starting Keppra photopsias resolved...Patient at the discharge was diagnosed with new onset focal seizures vs status epilepticus amauroticus.
- |||||||||| ketamine / Generic mfg., levetiracetam / Generic mfg., fosphenytoin / Generic mfg.
Regional Epidemiology of Status Epilepticus: Determinants for Healthcare Cost and Outcome in Central New York (Both in-person and online) - Mar 12, 2023 - Abstract #AAN2023AAN_1250;
Likewise, the various anesthetic regimen - including midazolam, propofol, pentobarbital, and ketamine - be it alone or in combination, did not alter the course of refractoriness or affect the final outcome...Conclusions We described the regional SE demographics, management and prognosis in CNY and further, defined the factors determining the cost-effective care. These findings can be used for regional healthcare and planning optimization.
- |||||||||| levetiracetam / Generic mfg.
Trial completion date, Trial primary completion date: STING: Seizure Treatment in Glioma (clinicaltrials.gov) - Mar 9, 2023
P4, N=120, Recruiting,
Further well-designed, prospective trials are warranted. Trial completion date: Jan 2027 --> Jan 2028 | Trial primary completion date: Jan 2025 --> Jan 2026
- |||||||||| Review, Journal: Epilepsy and brain tumors: Two sides of the same coin. (Pubmed Central) - Mar 7, 2023
Future trials with a prospective, randomized, and controlled design accounting for different prognostic factors will help clarify the role of these ASMs and the clinical setting in which they might be used. In conclusion, brain tumor-related epilepsies are clear examples of how close, multidisciplinary collaborations among investigators with different expertise are warranted for pursuing scientific knowledge and, more importantly, for the well-being of patients needing targeted and effective therapies.
- |||||||||| levetiracetam / Generic mfg., lamotrigine liquid oral suspension / OWP Pharma, Aptiom (eslicarbazepine) / Sumitomo Dainippon, BIAL
P4 data, Journal: Time to baseline seizure count in patients with focal seizures receiving adjunctive eslicarbazepine acetate in a phase IV clinical trial. (Pubmed Central) - Mar 6, 2023
This analysis of the Phase IV clinical trial data provides an alternative way of assessing efficacy beyond standardized seizure frequency reduction, in the context of relatively low monthly median seizure frequencies at baseline (SSF 2.0-2.4). These results provide further support for the use of ESL as an earlier or later adjunctive therapy to LEV or LTG.
- |||||||||| Nuplazid (pimavanserin) / Acadia Pharma
Journal: Channeling of New Neuropsychiatric Drugs-Impact on Safety and Effectiveness Studies. (Pubmed Central) - Mar 3, 2023
Propensity score non-overlap should be reported in comparative studies that include newer medications. When studies comparing newer and established treatments are critically needed as soon as new treatments enter the market, investigators should recognize the potential for channeling bias and implement methodological approaches like those demonstrated in this study to understand and improve this issue in such studies.
- |||||||||| levetiracetam / Generic mfg.
Trial completion date, Trial primary completion date: R33: Levetiracetam in Early Psychosis (clinicaltrials.gov) - Mar 1, 2023
P2, N=84, Recruiting,
ANN NEUROL 2023;93:551-562. Trial completion date: Jan 2023 --> Jan 2024 | Trial primary completion date: Jan 2023 --> Jan 2024
- |||||||||| levetiracetam / Generic mfg.
Enrollment closed: Pharmacological Modulation of Hippocampal Activity in Psychosis 2 (clinicaltrials.gov) - Feb 14, 2023
P2, N=62, Active, not recruiting,
Trial completion date: Jan 2023 --> Jan 2024 | Trial primary completion date: Jan 2023 --> Jan 2024 Recruiting --> Active, not recruiting
- |||||||||| levetiracetam / Generic mfg.
Review, Journal: Emotional Arousal Impacts Physical Health in Dogs: A Review of Factors Influencing Arousal, with Exemplary Case and Framework. (Pubmed Central) - Feb 12, 2023
The emotional health assessment and treatment of this case is described along with the short and long term (fourteen month follow up) outcomes to demonstrate that some patients presenting in this way can be effectively managed with an appropriate behavioural medicine treatment plan. The authors put forward the argument that an emotional health assessment should be considered an essential component of the work up of all such cases.
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