- |||||||||| Fycompa (perampanel) / Eisai
Observational data, Retrospective data, Journal: Effectiveness and safety of perampanel in Chinese paediatric patients (2-14 years) with refractory epilepsy: a retrospective, observational study. (Pubmed Central) - Mar 8, 2022 Perampanel was more effective in patients concomitantly treated with levetiracetam, however, this did not result in significantly more adverse events, including aggression. The present study suggests that perampanel, with or without concomitant oxcarbazepine or levetiracetam, is generally safe, well-tolerated, and efficacious in paediatric patients with uncontrolled epilepsy in a clinical setting.
- |||||||||| levetiracetam / Generic mfg.
Clinical, Retrospective data, Journal: Treatment outcomes in women with idiopathic generalized epilepsy. (Pubmed Central) - Mar 8, 2022 Decreasing use of valproate in WWE did not increase the risk of seizure recurrence; therefore, valproate alternatives could be considered as first-line ASMs for WWE. Overall, IGE patients demonstrated good clinical outcomes with valproate or other broad-spectrum ASMs as monotherapy.
- |||||||||| levetiracetam / Generic mfg.
Levetiracetam Associated Mental and Behavioural Abnormalities: A Systematic Review of Descriptive Studies (Virtual) - Mar 8, 2022 - Abstract #ISPOR2022ISPOR_585; Conclusion : Clinicians should be aware of the possible mental and behavioural abnormalities due to levetiracetam with their practice in clinical settings. Dose reduction or modification, treatment substitution, immediate or eventual treatment cessation seems to be effective in the management of levetiracetam associated mental and behavioural abnormalities.
- |||||||||| clonazepam / Generic mfg., sodium valproate / Generic mfg., levetiracetam / Generic mfg.
Review, Journal: Lance Adams syndrome: two cases report and literature review. (Pubmed Central) - Mar 8, 2022 Valproic acid, clonazepam and other antiepileptic drugs can be used. Whether levetiracetam is effective for cortical myoclonus requires further clinical study.
- |||||||||| Vimpat (lacosamide) / UCB, Daiichi Sankyo
Use of Lacosamide in Neonatal Seizures (Poster Hall) - Mar 6, 2022 - Abstract #AAN2022AAN_4018; Lacosamide was a well-tolerated adjunctive medication for treating seizures in our neonatal population with a greater than 50% reduction in seizure seen in 61%. Dosing regimens in neonates were similar to those utilized in older children.
- |||||||||| levetiracetam / Generic mfg., sotalol / Generic mfg.
De novo KCND3 Causing Encephalopathy and Cardiac Arrhythmias: A Case Report (Poster Hall) - Mar 6, 2022 - Abstract #AAN2022AAN_3705; This unique presentation of a KCND3 mutation demonstrates that Kv4.3 mutations cause concomitant developmental delays, epilepsy, and cardiac arrhythmias. Investigating the simultaneous occurrence of neurologic and cardiac disease in gain of function mutations of KCDN3 is worthwhile.
- |||||||||| Vimpat (lacosamide) / UCB, Daiichi Sankyo
Trends in Antiseizure Medication Fills and Cost in Medicare Beneficiaries with Epilepsy (Poster Hall) - Mar 6, 2022 - Abstract #AAN2022AAN_3375; While brand name ASMs initially waned translating into lower costs and likely higher value care, after 2010 brand name costs markedly increased due to increasing use of lacosamide in addition to escalating per-pill cost of brand name ASMs. Further work is needed to understand drivers of brand name use to inform cost containment efforts.
- |||||||||| levetiracetam / Generic mfg.
Petechiae: An Atypical Initial Presentation of Seizure (Poster Hall) - Mar 6, 2022 - Abstract #AAN2022AAN_3373; Mechanism of petechiae is likely associated with extravasation of RBCs due to increased intrathoracic pressure causing ruptured capillaries. In our patient petechiae did not return after initiation of levetiracetam.
- |||||||||| Keytruda (pembrolizumab) / Merck (MSD)
A case of pembrolizumab related PRES (Poster Hall) - Mar 6, 2022 - Abstract #AAN2022AAN_3362; PRES is a rare complication associated with pembrolizumab therapy. As pembrolizumab continues to gain FDA approval to treat different cancers, more research is needed to identify what factors may place patients at a higher risk for this life-threatening therapy-related complication.
- |||||||||| Vimpat (lacosamide) / UCB, Daiichi Sankyo
A Rare Case of Adult Onset Mitochondrial Encephalomyopathy, Lactic Acidosis and Stroke-like Episodes at Age 60 (Poster Hall) - Mar 6, 2022 - Abstract #AAN2022AAN_3337; Patient discharged on Eliquis and Depakote given concerns of epileptogenicity of temporal lobe lesions...Medications adjusted until Levetiracetam and Lacosamide achieved seizure control... This case highlights the importance of considering MELAS in suspected stroke with continued clinical deterioration and progressive MRI changes.
- |||||||||| zonisamide / Generic mfg., levetiracetam / Generic mfg., oxcarbazepine / Generic mfg.
A Case of CHD2 Epileptic Encephalopathy (Poster Hall) - Mar 6, 2022 - Abstract #AAN2022AAN_3326; This case demonstrates an example of genetic testing providing a diagnosis that directly impacted patient care. Improved seizure control was attained when the genetic diagnosis suggested a generalized-onset epilepsy that was exacerbated by a narrow-spectrum anti-seizure medication, despite focal epileptiform discharges on EEG.
- |||||||||| ketamine / Generic mfg.
New-Onset Refractory Status Epilepticus After Pfizer-BioNTech COVID-19 Vaccination (Poster Hall) - Mar 6, 2022 - Abstract #AAN2022AAN_3093; To our knowledge, this is the first case of NORSE reported after Pfizer COVID-19 vaccination. While no test exists to definitively establish causality, these findings warrant further investigation of the possible association between COVID-19 vaccination and autoimmune encephalitis.
- |||||||||| clonazepam / Generic mfg.
Atypical Presentation of Lance Adams Syndrome in the setting of Clonazepam overdose and SARS-CoV-2 pneumonia (Poster Hall) - Mar 6, 2022 - Abstract #AAN2022AAN_3092; The patient exhibited stimulus induced myoclonic jerking which lasted >30 minutes despite being loaded on valproic acid and levetiracetam. The atypical presentation of this case emphasizes the importance of distinguishing LAS from MSE to guide neurologists to aggressively treat LAS to improve outcome, particularly since MSE historically results with a 90-100% mortality rate.
- |||||||||| phenytoin / Generic mfg., levetiracetam / Generic mfg.
Hypoxic-ischemic Injury as a Rare Complication of Sudden Severe Anemia (Poster Hall) - Mar 6, 2022 - Abstract #AAN2022AAN_2942; Sudden, severe anemia is a rare cause of hypoxic-ischemic injury. Patients with neurological deficits after hemorrhage may benefit from dedicated neuroimaging to assess for this.
- |||||||||| pregabalin / Generic mfg., gabapentin / Generic mfg.
Safety Profiles of Second-Generation Antiseizure Medications: A Pharmacovigilance Study (Poster Hall) - Mar 6, 2022 - Abstract #AAN2022AAN_2885; This comprehensive analysis of postmarketing data from the FDA Adverse Event Database shows differences in safety profiles between new generation ASMs. Rigorous post-market surveillance and further research is required to better understand the long-term safety of these drugs to make informed clinical decisions.
- |||||||||| everolimus / Generic mfg., carbamazepine / Generic mfg.
Everolimus for Treatment of Refractory Seizures in Tuberous Sclerosis (Poster Hall) - Mar 6, 2022 - Abstract #AAN2022AAN_2884; She was on Phenytoin and brivaracetam when she presented to us and was experiencing 5-6 seizures per month... Everolimus has been shown to be of tremendous benefit to Tuberous Sclerosis patients, both in reducing tumor size as well as a treatment for intractable epilepsy. Physicians should consider the use of Everolimus as an adjunctive treatment for refractory epilepsy in patients with Tuberous sclerosis to help decrease seizure burden and improve quality of life.
- |||||||||| levetiracetam / Generic mfg.
Antiseizure drugs adherence in elderly patients with epilepsy (Poster Hall) - Mar 6, 2022 - Abstract #AAN2022AAN_2883; The most prescribed anti seizure medication was lamotrigine 48 (41%), followed by levetiracetam 40 (34.5%)... The present study showed high therapeutic adherence to anti seizure medication in older adults; which was associated with favorable clinical outcome.
- |||||||||| levetiracetam / Generic mfg.
The Effects of Pregnancy on Levetiracetam Levels and Seizure Frequency (Poster Hall) - Mar 6, 2022 - Abstract #AAN2022AAN_2731; Seizure-free patients at baseline that remained seizure free maintained higher serum levels of levetiracetam demonstrating higher average percentage increases in their serum levels. Following frequent levetiracetam levels and adjusting dosage accordingly throughout pregnancy will minimize breakthrough seizure frequency.
- |||||||||| levetiracetam / Generic mfg., clobazam / Generic mfg.
Brain Dead or Alive: Pitfalls in Neurological Prognostication (Poster Hall) - Mar 6, 2022 - Abstract #AAN2022AAN_2431; The lack of uniformity when approaching comatose patients with presumed irreversible neurologic injury can lead to inaccurate prognostication and guide life-or-death clinical decisions. This case of erroneous assessment highlights the marked limitations of the current legal framework for determining brain death under the UDDA and the need for standardized medical criteria.
- |||||||||| carbamazepine / Generic mfg.
Therapeutic Basis of Generic Substitution of Antiseizure Medications () - Mar 6, 2022 - Abstract #AAN2022AAN_2215; Rather, it is imperativethat physicians and pharmacists provide adequate patient education on what to expect whenswitching to generic ASMs, including changes in medication shape and color. Anothersuggestion would be to consider that all ASMs be considered for inclusion in NTI class toprevent the clinical outcome issues associated with generic ASM switching.
- |||||||||| levetiracetam / Generic mfg., topiramate / Generic mfg., ethosuximide / Generic mfg.
Patterns of medication use in patients with rare Mendelian pediatric epilepsies ([VIRTUAL]) - Mar 6, 2022 - Abstract #AAN2022AAN_1971; Future research could further examine medication patterns, including genetic or phenotypic correlates of medication efficacy. Such studies may help improve seizure management for patients with these rare epilepsies.
- |||||||||| Piqray (alpelisib) / Novartis
Alpelisib induced diabetes ketoacidosis and resultant status epilepticus ([VIRTUAL]) - Mar 6, 2022 - Abstract #AAN2022AAN_1674; Design/ A 60-year-old Caucasian female with history of breast cancer with metastasis to brain, bone,and thyroid, was admitted following syncope.She was taking alpelisib with fulvestrant as the tumor was ER/PR positive, HER-2/neu negative, and PIK3CA mutation-positive.Her disease had progressed on previous endocrine therapy.She was on metformin for prediabetes.On admission, she was afebrile, hemodynamically stable, and had no neurological deficits.MRI brain showed focal extra-axial density along the right anterior frontal lobe and mottled appearance of skull representing known multifocal bony metastases(figures 1& 2).During hospitalization, she developed DKA- glucose 513mg/dL, bicarbonate14, anion gap21, and pH7.3 resulting in status epilepticus with generalized tonic-clinic seizures, requiring intravenous levetiracetam and lorazepam.She was intubated for airway protection.Subsequent electroencephalogram showed prolonged study with presence of burst suppression activity and phase reversals in right temporal region. PI3KCA inhibitors are promising drugs in patients with metastatic breast cancer who have not responded to previous treatment;the SOLAR-1 trial showed 35% risk reduction in cancer progression and death.However, these patients are at risk of metabolic derangement with hyperglycemia and DKA, a potential limiting side-effect.The optimal management of hyperglycemia-induced by alpelisib warrants further research.
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