- |||||||||| carbamazepine / Generic mfg.
Journal: Epilepsy and pregnancy. Factors associated with epileptic seizures during pregnancy. (Pubmed Central) - Jul 22, 2020
The factors associated with the presence of seizures during pregnancy were previous poor seizure control, treatment with 2 or more antiepileptic drugs, and lack of treatment during pregnancy. The most commonly used drugs were lamotrigine, valproate, and levetiracetam, with an increase in levetiracetam use and a decrease in valproate use being observed in the later period (2011-2018).
- |||||||||| levetiracetam / Generic mfg.
Clinical, Journal: Treatment decisions in women of childbearing age on valproate. (Pubmed Central) - Jul 21, 2020
Women taking valproate are better informed than those on levetiracetam or lamotrigine. Information provision on the use of folic acid and contraception needs improvement.
- |||||||||| vigabatrin / Generic mfg., levetiracetam / Generic mfg.
Clinical, Journal: Oral Findings in Children, Adolescents and Adults with Tuberous Sclerosis Complex. (Pubmed Central) - Jul 17, 2020
Although gingival fibromas in TSC are independent of patient's age, young age, anticonvulsant therapy and local factors increase their severity. Enamel defects in TSC include pits, but also enamel loss on the incisal edges and tooth wear.
- |||||||||| levetiracetam / Generic mfg.
Clinical, Journal: Valproate and female patients: Prescribing attitudes of Italian epileptologists. (Pubmed Central) - Jul 16, 2020
The main challenges were represented by women with JME, who were seizure-free on VPA and failed to respond to levetiracetam and lamotrigine, and by little girls for whom VPA was considered the best choice. According to many Italian epileptologists, the decision to withdraw VPA should be shared with the patient.
- |||||||||| levetiracetam / Generic mfg.
Journal: Cognitive profile in BECTS treated with levetiracetam: A 2-year follow-up. (Pubmed Central) - Jul 16, 2020
According to many Italian epileptologists, the decision to withdraw VPA should be shared with the patient. Not only do our data suggest a nonworsening of the cognitive profile in BECTS with LEV but, on the contrary, cognitive scores also improved over time, unlike the control group.
- |||||||||| levetiracetam / Generic mfg., carbamazepine / Generic mfg., dronabinol oral / Generic mfg.
[VIRTUAL] Levetiracetam in Management of Bilateral Trigeminal Neuralgia Due to Large Glomus Tumor () - Jul 15, 2020 - Abstract #AHS2020AHS_186;
Levetiracetam may be an option in treatment of trigeminal neuralgia who either are not improved on first line treatments or are unable to tolerate them. Relatively low side effect profile and availability of intravenous formulations are advantages for this medication during exacerbation periods.
- |||||||||| levetiracetam / Generic mfg.
Trial completion date, Trial primary completion date: Levetiracetam in Early Psychosis (clinicaltrials.gov) - Jul 10, 2020
P2, N=32, Recruiting,
Relatively low side effect profile and availability of intravenous formulations are advantages for this medication during exacerbation periods. Trial completion date: Oct 2019 --> Dec 2020 | Trial primary completion date: Oct 2019 --> Dec 2020
- |||||||||| carbamazepine / Generic mfg.
Journal: New recommendations for antiepileptic drug therapy: the last piece in the review of epilepsy care (Pubmed Central) - Jul 9, 2020
Lamotrigine, levetiracetam and valproic acid are first-line options for generalized seizures. However, valproic acid is contraindicated during pregnancy unless there is no other effective treatment available, as well as for fertile girls/women unless the conditions of a specific pregnancy prevention programme are met.
- |||||||||| levetiracetam / Generic mfg.
Clinical, Journal, HEOR: Quality of life after switching to generic levetiracetam - A prospective comparative study. (Pubmed Central) - Jul 8, 2020
We hypothesize that the nurse-led structured follow-up had an impact on seizure worries and switchback rates because of reduced nocebo effects. Further studies on generic AED substitution, focusing on psychological outcome measures, are warranted to test this supposition.
- |||||||||| carbamazepine / Generic mfg.
Journal: Self-reported attitudes about medication in Lebanese people with epilepsy. (Pubmed Central) - Jul 8, 2020
Depression and economic burden were the major factors that decreased these attitudes. Identifying factors affecting attitudes to medication and leading to controlled epilepsy may help clinicians to elaborate educational programs to optimize medication adherence.
- |||||||||| carbamazepine / Generic mfg., Trileptal (oxcarbazepine) / Novartis
Journal: Antiepileptic Drug Exposure in Infants of Breastfeeding Mothers With Epilepsy. (Pubmed Central) - Jul 7, 2020
Overall, antiepileptic drug concentrations in blood samples of infants who were breastfed were substantially lower than maternal blood concentrations. Given the well-known benefits of breastfeeding and the prior studies demonstrating no ill effects when the mother was receiving antiepileptic drugs, these findings support the breastfeeding of infants by mothers with epilepsy who are taking antiepileptic drug therapy.
- |||||||||| levetiracetam / Generic mfg.
[VIRTUAL] PRES in a Normotensive Patient with Sickle Cell Disease: Low Pressure, Alarming Consequences (ATS 2020 Virtual) - Jul 6, 2020 - Abstract #ATSI2020ATS-I_7106;
The patient was given a loading dose of levetiracetam and intravenous hydration with normal saline...High clinical suspicion is required to make this diagnosis especially when convoluted neurological symptoms may favor stroke. Making this distinction will ensure appropriate management of PRES and avoid unnecessary initiation of a chronic transfusion program aimed at stroke prevention in SCD patients.
- |||||||||| pregabalin / Generic mfg., cyclophosphamide intravenous / Generic mfg., Rituxan (rituximab) / Biogen, Zenyaku Kogyo, Roche
[VIRTUAL] A Journey Through the Endless Pursuit: Challenges with Refractory Status Epilepticus (ATS 2020 Virtual) - Jul 6, 2020 - Abstract #ATSI2020ATS-I_6886;
Patients with NORSE/FIRES present as both a diagnostic and therapeutic challenge, which is illustrated in this case. The paucity of data on these syndromes translates into a lack of data on treatment options, highlighting the need for increased awareness among medical providers, the importance of the existence of a registry and publications of individual case reports that contribute to the literature and foster further investigation.
- |||||||||| ceftriaxone / Generic mfg.
[VIRTUAL] Postictal Pulmonary Edema - A Forgotten Entity (ATS 2020 Virtual) - Jul 6, 2020 - Abstract #ATSI2020ATS-I_6884;
She presented to the emergency room in a postictal state following a grand mal seizure after missing two doses of regularly-prescribed levetiracetam...She initially received inhaled tranexamic acid for concern for diffuse alveolar haemorrhage and vancomycin, levofloxacin, and ceftriaxone empirically and then continued on azithromycin for concern for atypical pneumonia...It has been postulated that pulmonary venoconstriction secondary to intracranial hypertension and sympathetic stimulation causes pulmonary edema by increasing pulmonary capillary hydrostatic pressure. Increased pulmonary capillary permeability is also implicated, but the mechanism is yet to be completely delineated.
- |||||||||| sertraline / Generic mfg.
[VIRTUAL] SAH Due to SSRI Use: Reversible Cerebral Vasoconstriction Syndrome (ATS 2020 Virtual) - Jul 6, 2020 - Abstract #ATSI2020ATS-I_6879;
She was started on Nimodipine and Keppra...Zoloft was discontinued...Neurological deficits are usually reversible but rarely permanent disability can occur. It is important to distinguish RCVS from serious secondary causes such as ruptured brain aneurysm, stroke and cervical artery dissection.
- |||||||||| levetiracetam / Generic mfg., Pradaxa (dabigatran etexilate) / Boehringer Ingelheim
[VIRTUAL] Bleeding Out: Acute Hemorrhagic Stroke in a Patient with Metastatic Carcinoma Following Appropriate Anticoagulation Usage (ATS 2020 Virtual) - Jul 6, 2020 - Abstract #ATSI2020ATS-I_6878;
He had scalp melanoma and had been on dabigatran for recurrent pulmonary embolism...The patient was immediately started on protamine sulfate and admitted to the neurocritical care service with recommendations for neurosurgical intervention and to treat his condition medically with blood pressure control, levetiracetam for seizure prophylaxis, and intravenous saline infusion to prevent cranial herniation...Likewise, further studies in optimal LMWH administration frequency and dosing would be beneficial in this population to determine optimal dosing while remaining therapeutic. For patients presenting with venous thrombosis and co- existing metastatic intracranial carcinoma, we recommend intervention with mechanical thrombectomy or frequent neurological assessments and radiography if anticoagulation use is unavoidable.
- |||||||||| dexamethasone / Generic mfg., levetiracetam / Generic mfg.
[VIRTUAL] Multiple Cystic Brain Lesions: An Atypical Presentation of Metastatic Lung Cancer (ATS 2020 Virtual) - Jul 6, 2020 - Abstract #ATSI2020ATS-I_6148;
Biopsy of brain lesions is not necessary to establish a diagnosis if the lesions occur in the setting of pre-existing malignancy, however, it should be considered in other scenarios. It is important to keep metastatic lesions in differentials of multiple cystic brain lesions, along with infectious processes including neurocysticercosis, especially in endemic areas of South America and Africa.
- |||||||||| levetiracetam / Generic mfg.
[VIRTUAL] A Case of Eosinophilic Pneumonia Induced by Levetiracetam (ATS 2020 Virtual) - Jul 6, 2020 - Abstract #ATSI2020ATS-I_5322;
Levetiracetam was discontinued and he was started on prednisone...He was switched to lacosamide for long-term anti-epileptic therapy and eventually discharged from the hospital...We detail the time course of drug exposure with peripheral and pulmonary eosinophilia and show resolution of his syndrome with corticosteroids. Additionally, our case includes follow-up imaging to demonstrate time to radiographic improvement.
- |||||||||| Vimpat (lacosamide) / UCB, Daiichi Sankyo
[VIRTUAL] Suppressing All the Electricity: A Case of Lacosamide Induced Atrioventricular Block (ATS 2020 Virtual) - Jul 6, 2020 - Abstract #ATSI2020ATS-I_4345;
Description of case report A 58-year-old female with a history of juvenile rheumatoid arthritis requiring chronic Prednisone and multiple orthopedic procedures was admitted to the hospital for acute blood loss anemia secondary to a post-operative infected wound following a left hip disarticulation...She continued to have generalized periodic epileptiform discharges despite levetiracetam and phenytoin and the decision was made to add lacosamide following discussion with neurology...Lacosamide was discontinued and topiramate was started...The adjustment in medications quickly results in resolution of the AV block. It is important to always consider medication side effect as the etiology for heart block.
- |||||||||| levetiracetam / Generic mfg., apixaban / Generic mfg.
[VIRTUAL] ST Segment Changes in Hyperthermia; Infarct or Fiction? (ATS 2020 Virtual) - Jul 6, 2020 - Abstract #ATSI2020ATS-I_4339;
An LP was considered, but due to recent apixaban use was delayed...While a Brugada type 1 pattern can be seen in hyperthermia our patient did not have these findings on ECG. It is important to recognize these cases in order to differentiate life threatening illness with an underlying metabolic and reversible cause.
- |||||||||| carbamazepine / Generic mfg.
[VIRTUAL] Paroxysmal Sympathetic Hyperactivity in Glioblastoma Multiforme (ATS 2020 Virtual) - Jul 6, 2020 - Abstract #ATSI2020ATS-I_3073;
Due to low prevalence and complex pathophysiology, this syndrome is not well understood and often presents as a diagnostic dilemma.A 44-year-old male with a history of glioblastoma multiforme status-post right hemicraniectomy presented to the emergency department with acute encephalopathy and episodic seizure like activity despite being on carbamazepine and levetiracetam...Patient was started on IV labetalol and clonidine maintaining strict control for paroxysmal episodes...Having a high index of suspicion among patients with traumatic brain injury can aid in detecting the presence of this syndrome early in progression of disease. Timely identification can help in preventing delays in receiving appropriate treatment due to repetitive lab testing and might lead to better outcomes.
- |||||||||| [VIRTUAL] A Rare Case of Myeloid Sarcoma Presenting as Acute Cerebrovascular Accident (ATS 2020 Virtual) - Jul 6, 2020 - Abstract #ATSI2020ATS-I_3069;
The patient was initiated on dexamethasone and levetiracetam on admission and admitted to the neuro-intensive care unit...His current treatment plan consists of alternating weeks of intrathecal cytarabine and methotrexate...Further complicating this clinical scenario was the more recent history of non-small cell lung carcinoma, which could also represent another primary site of metastasis. Clinical suspicion of myeloid sarcoma must be entertained in patient with history of acute myeloid leukemia regardless of remission status.
- |||||||||| bromocriptine / Generic mfg.
[VIRTUAL] Unusual Trigger and Presentation of Neuroleptic Malignant Syndrome (ATS 2020 Virtual) - Jul 6, 2020 - Abstract #ATSI2020ATS-I_3052;
Anti-seizure regimen at the time included Clobazam, as well as Levetiracetam and Valproate, both of which dosages had been increased three months earlier...Azithromycin was added, however patient's hypoxemic respiratory failure worsened requiring intubation...One week passed by, and despite improvement in respiratory status, he continued spiking fevers therefore Bromocriptine was started given high suspicion for NMS...This case remains unique given the scant number of cases in literature of Valproate-induced NMS, and merits further awareness given he was not and had not been on any classic dopamine depleting central nervous system (CNS) medications at the time symptoms started. Important to note, patient had other risk factors that have been associated with NMS, such as mental retardation, low hemoglobin, and possibly a genetic syndrome given early onset epilepsy and autism that should be taken into consideration.
- |||||||||| Vimpat (lacosamide) / UCB, Daiichi Sankyo, ketamine / Generic mfg., levetiracetam / Generic mfg.
[VIRTUAL] Baclofen Overdose Associated with Prolonged Super-Refractory Status Epilepticus (ATS 2020 Virtual) - Jul 6, 2020 - Abstract #ATSI2020ATS-I_3050;
EEG continued to show ictal activity over the next several days despite additional therapy with phenobarbital and lacosamide...Propofol and midazolam were weaned on hospital day 8, and EEG progressed to NCSE that resolved with initiation of ketamine...The etiology of our patient's prolonged NCSE was unclear but may be related to her temporal lobe venous abnormality. With increased prescribing of baclofen, it is important for critical care physicians to be aware of the clinical characteristics of overdose including the potential for an extended duration of symptoms.
- |||||||||| Vimpat (lacosamide) / UCB, Daiichi Sankyo
[VIRTUAL] Lacosamide and Metoprolol: An Uncommon Yet Potentially Deadly Combination (ATS 2020 Virtual) - Jul 6, 2020 - Abstract #ATSI2020ATS-I_3044;
He again developed atrial fibrillation with RVR that improved with amiodarone...It is crucial that clinicians are acutely aware of potentially deadly interactions to prevent adverse patient outcomes. This remains especially true in the ICU where DDI can easily be overlooked with the tremendous cocktails of medications patients receive on a daily basis.
- |||||||||| levetiracetam / Generic mfg.
[VIRTUAL] Do Not Throw in the Towel Too Soon: A Rare Case of Neurotoxicity Due to Alpha-Cypermethrin Toxicity (ATS 2020 Virtual) - Jul 6, 2020 - Abstract #ATSI2020ATS-I_3040;
Continuous EEG showed epileptiform discharges, and midazolam drip dose was increased and levetiracetam was added...Most common symptoms of toxicity are gastrointestinal symptoms and it may mimic organophosphate poisoning due to its cholinergic actions. Our case demonstrates remarkably prolonged coma state in a patient with alpha-cypermethrin toxicity and highlights the importance of appropriate watchful waiting before making decision to withdraw care.
- |||||||||| levetiracetam / Generic mfg., escitalopram / Generic mfg.
[VIRTUAL] A Fatal Case of Valproic Acid-Induced Cerebral Edema (ATS 2020 Virtual) - Jul 6, 2020 - Abstract #ATSI2020ATS-I_3026;
The patient was started on Valproic Acid and Escitalopram while waiting for inpatient psychiatry placement...The patient continued to have seizures on maximal doses of Levetiracetam with no improvement in ammonia levels, which necessitated urgent hemodialysis...Given these potentially fatal complications, close attention should be paid to patients given VPA who present with symptoms concerning for encephalopathy. Early detection and treatment is critical for optimal patient outcomes.
- |||||||||| Cerebyx (fosphenytoin) / Pfizer, Nobelpharma
[VIRTUAL] Blocking the Wrong Channel - Bradyasystolic Arrest Following Fosphenytoin Infusion (ATS 2020 Virtual) - Jul 6, 2020 - Abstract #ATSI2020ATS-I_3018;
She developed seizures, requiring administration of lorazepam and intubation for airway protection...Keppra was initiated for seizure prophylaxis...Possible mechanisms include rapid conversion to phenytoin and other metabolites with prodysrhythmic properties and transient hypocalcemia and consequent QTc prolongation due to the presence of phosphate causing a predisposition to arrhythmia. While the incidence of dysrhythmia appears to be less frequent than with phenytoin, healthcare providers should remain vigilant for their occurence when administering fosphenytoin.
- |||||||||| levetiracetam / Generic mfg.
Clinical, Journal: Identification of Risk Factors for Refractory Status Epilepticus. (Pubmed Central) - Jul 5, 2020
This information can be used to potentially identify patients at higher risk of developing RSE, so that treatment can be modified to reduce morbidity and mortality. These results may warrant further investigation into the effectiveness of levetiracetam as a first-line agent for the treatment of SE.
- |||||||||| carbamazepine / Generic mfg., Trileptal (oxcarbazepine) / Novartis
Clinical, Journal: Treatment of Juvenile Myoclonic Epilepsy in Patients of Child-Bearing Potential. (Pubmed Central) - Jul 4, 2020
Alternatives have emerged, especially lamotrigine and levetiracetam, but also topiramate, zonisamide, and recently perampanel, but none of these AEDs can be considered fully safe in the context of pregnancy...Carbamazepine, oxcarbazepine and phenytoin must be avoided...The consequences of a lifetime of poorly controlled epilepsy need to be balanced against the teratogenic risks of valproate during limited times in a woman's life. The management of JME in WWE should include lifestyle interventions, with avoidance of sleep deprivation, and planned pregnancy.
- |||||||||| Vimpat (lacosamide) / UCB, Daiichi Sankyo, levetiracetam / Generic mfg., levetiracetam low dose (AGB101) / AgeneBio
Retrospective data, Journal, Monotherapy: Long-term efficacy and safety of lacosamide and levetiracetam monotherapy in elderly patients with focal epilepsy: A retrospective study. (Pubmed Central) - Jul 4, 2020
In this retrospective real-life study, the efficacy and the tolerability of LCM as monotherapy was favorable even at low doses in older patients and comparable with LEV with a high rate of long-term seizure freedom. Considering the frequent comorbidities and the risk of drug-drug interactions, LCM monotherapy may be a valuable option in elderly patients with focal onset epilepsy because of its favorable pharmacokinetic profile.
- |||||||||| levetiracetam / Generic mfg.
Clinical, Journal: Neuronal antibodies in adult patients with new-onset seizures: A prospective study. (Pubmed Central) - Jul 4, 2020
Considering the frequent comorbidities and the risk of drug-drug interactions, LCM monotherapy may be a valuable option in elderly patients with focal onset epilepsy because of its favorable pharmacokinetic profile. We conclude that indiscriminate testing in patients presenting to a first seizure clinic with new-onset seizures or epilepsy is unlikely to improve detection of autoimmune epilepsy.
- |||||||||| levetiracetam / Generic mfg., carbamazepine / Generic mfg.
Review, Journal: Levetiracetam versus carbamazepine in treatment of rolandic epilepsy. (Pubmed Central) - Jul 2, 2020
Physicians taking care of children with RE should be aware of the risks for cognitive dysfunctions in these patients and screen their patients for any subtle dysfunction that may affect their academic performance and achievement. If and when the physician decides to prescribe an AED for their patients with RE, LEV is probably a better option compared with CBZ to prescribe for these children.
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