- |||||||||| Rituxan (rituximab) / Roche, Biogen, Zenyaku Kogyo
[VIRTUAL] CNS Immunoglobulin G4-related disease: more than hypertrophic meningitis (Room: Screen A10) - Apr 9, 2020 - Abstract #EAN2020EAN_1489;
A neurological presentation including leptomeningitis is highlighted and may represent a different form of IgG4- RD. We emphasize the importance of considering the disease on differential diagnosis of unclear leptomeningeal disease.
- |||||||||| Vistide (cidofovir) / Gilead, carbamazepine / Generic mfg.
[VIRTUAL] Severe human herpesvirus 7 (HHV-7) encephalitis in a patient with rheumatoid arthritis (Room: Screen B6) - Apr 9, 2020 - Abstract #EAN2020EAN_1465;
The pathogenic role of HHV-7 in encephalitis is controversial but it should be considered and aggressively treated in immunosuppressed patients. The current case reports the evolution of HHV-7 encephalitis which can contribute to the current knowledge of this serious disease.
- |||||||||| levetiracetam / Generic mfg.
[VIRTUAL] A rare case of adult onset neuronal intranuclear disease (Room: Screen A1) - Apr 9, 2020 - Abstract #EAN2020EAN_1094;
It reminds us of the importance of keeping broad differentials in mind when dealing with encephalopathy. NIID is increasingly recognised as an under diagnosed entity and an important differential diagnosis of leukoencephalopathy and neuropathy.
- |||||||||| Vimpat (lacosamide) / UCB, Daiichi Sankyo, levetiracetam / Generic mfg.
[VIRTUAL] Seizure freedom in patients treated with lacosamide and levetiracetam (ePoster) - Apr 9, 2020 - Abstract #EAN2020EAN_512;
The addition of lacosamide and levetiracetam in our series achieve a tendency of greater proportion of seizure free patients in comparison to other treatments, which is important to consider in our daily medical practice. It is necesary to have studies with greater sample to confirm the results.
- |||||||||| levetiracetam / Generic mfg.
Trial completion, Enrollment change: Levetiracetam in the Management of Bipolar Depression (clinicaltrials.gov) - Mar 31, 2020
P=N/A, N=35, Completed,
In addition, our data support levetiracetam as the most promising TBI drug candidate screened by OBTT to date. Recruiting --> Completed | N=50 --> 35
- |||||||||| temozolomide / Generic mfg., levetiracetam / Generic mfg.
Retrospective data, Journal: Effect of anti-epileptic drugs on the survival of patients with glioblastoma multiforme: A retrospective, single-center study. (Pubmed Central) - Mar 29, 2020
The use of LEV in the group with a methylated MGMT promoter resulted in a positive impact on the OS [P = 0.006; HR, 0.174; 95% CI: 0.050-0.608], but the effect of LEV on the OS was not statistically significant in the unmethylated MGMT promoter group (P = 0.623). This study suggests that, compared with other AEDs, the administration of LEV may prolong the survival period in GBM patients with methylated MGMT promoters, who are undergoing chemotherapy with TMZ.
- |||||||||| NN1213 / Novo Nordisk
Phase classification, Adverse events: BEEP2b: Characterization of Epilepsy Patients BEEP 2b (clinicaltrials.gov) - Mar 27, 2020
P1, N=21, Completed,
This study suggests that, compared with other AEDs, the administration of LEV may prolong the survival period in GBM patients with methylated MGMT promoters, who are undergoing chemotherapy with TMZ. Phase classification: P4 --> P1
- |||||||||| Trileptal (oxcarbazepine) / Novartis
First case report of Levetiracetam Induced MCD: Unicorn in the the barn () - Mar 27, 2020 - Abstract #NKFCSM2020NKF_CSM_362;
He was given IV methylprednisolone and started on PO prednisone daily...Steroids were stopped and patient was gradually tapered off from levetiracetam and started on oxcarbazepine... In patients with significant proteinuria, medications should be reviewed to exclude secondary MCD.
- |||||||||| levetiracetam / Generic mfg.
Enrollment closed, Trial completion date, Trial primary completion date: ILiAD: An Investigation of Levetiracetam in Alzheimer's Disease (clinicaltrials.gov) - Mar 27, 2020
P2, N=30, Active, not recruiting,
In patients with significant proteinuria, medications should be reviewed to exclude secondary MCD. Enrolling by invitation --> Active, not recruiting | Trial completion date: Jan 2020 --> Sep 2021 | Trial primary completion date: Nov 2019 --> Sep 2021
- |||||||||| levetiracetam low dose (AGB101) / AgeneBio
Clinical, Journal: Clinical Use and Efficacy of Levetiracetam for Absence Epilepsies. (Pubmed Central) - Mar 26, 2020
When effective, levetiracetam can control absence epilepsy at a relatively low dose. Lack of seizure control requiring continued dose escalation should prompt early consideration of a therapeutic medication transition.
- |||||||||| levetiracetam / Generic mfg.
Retrospective data, Journal: Efficacy and safety of levetiracetam in Japanese epilepsy patients: A retrospective cohort study. (Pubmed Central) - Mar 19, 2020
This study suggests that prophylactic AED should not be administered to prevent brain tumour-related epilepsy after craniotomy. Levetiracetam may be used effectively and safely without dose adjustment using blood concentration monitoring even when administered in combination with other antiepileptics for Japanese patients with epilepsy.
- |||||||||| carbamazepine / Generic mfg., Trileptal (oxcarbazepine) / Novartis
Journal, Adverse events: Adverse Skin Reactions with Antiepileptic Drugs Using Korea Adverse Event Reporting System Database, 2008-2017. (Pubmed Central) - Mar 17, 2020
When hypersensitivity skin reactions occurred, aromatic AEDs were associated with 4 fold the risk of SJS/TEN/DRESS compared with non-aromatic AEDs. Our findings further emphasize that high risk AEDs should be prescribed under careful monitoring, and early detection and prompt interventions are needed to prevent severe complications.
- |||||||||| levetiracetam / Generic mfg.
Clinical, Journal: Efficacy of Levetiracetam in Treatment of Childhood Stuttering. (Pubmed Central) - Mar 17, 2020
There were statistically significant differences for efficacy in the presence of variables such as age groups, seizure, stuttering family history, and EEG data. LEV is an effective drug for treatment of childhood stuttering in those that have abnormal sleep EEG.
- |||||||||| levetiracetam / Generic mfg.
PRES in a Normotensive Patient with Sickle Cell Disease: Low Pressure, Alarming Consequences (PENNSYLVANIA CONVENTION CENTER, Hall D-E (200 Level), Area F) - Mar 15, 2020 - Abstract #ATS2020ATS_9871;
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) / Roche, Biogen, Zenyaku Kogyo
A Journey Through the Endless Pursuit: Challenges with Refractory Status Epilepticus (PENNSYLVANIA CONVENTION CENTER, Hall D-E (200 Level), Area A) - Mar 15, 2020 - Abstract #ATS2020ATS_9617;
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.
Postictal Pulmonary Edema - A Forgotten Entity (PENNSYLVANIA CONVENTION CENTER, Hall D-E (200 Level), Area A) - Mar 15, 2020 - Abstract #ATS2020ATS_9615;
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.
SAH Due to SSRI Use: Reversible Cerebral Vasoconstriction Syndrome (PENNSYLVANIA CONVENTION CENTER, Hall D-E (200 Level), Area A) - Mar 15, 2020 - Abstract #ATS2020ATS_9610;
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
Bleeding Out: Acute Hemorrhagic Stroke in a Patient with Metastatic Carcinoma Following Appropriate Anticoagulation Usage (PENNSYLVANIA CONVENTION CENTER, Hall D-E (200 Level), Area A) - Mar 15, 2020 - Abstract #ATS2020ATS_9609;
Likewise, further studies inoptimal LMWH administration frequency and dosing would be beneficial in this population to determineoptimal dosing while remaining therapeutic. For patients presenting with venous thrombosis and co-existing metastatic intracranial carcinoma, we recommend intervention with mechanical thrombectomyor frequent neurological assessments and radiography if anticoagulation use is unavoidable.
- |||||||||| Decadron (dexamethasone) / Merck (MSD)
Multiple Cystic Brain Lesions: An Atypical Presentation of Metastatic Lung Cancer (PENNSYLVANIA CONVENTION CENTER, Hall D-E (200 Level), Area A) - Mar 15, 2020 - Abstract #ATS2020ATS_8803;
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.
- |||||||||| Vimpat (lacosamide) / UCB, prednisone / Generic mfg., levetiracetam / Generic mfg.
A Case of Eosinophilic Pneumonia Induced by Levetiracetam (PENNSYLVANIA CONVENTION CENTER, Hall D-E (200 Level), Area G) - Mar 15, 2020 - Abstract #ATS2020ATS_7888;
Eosinophilic pneumonia is a relatively rare cause of hypoxemic respiratory failure...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
Suppressing All the Electricity: A Case of Lacosamide Induced Atrioventricular Block (PENNSYLVANIA CONVENTION CENTER, Hall D-E (200 Level), Area K) - Mar 15, 2020 - Abstract #ATS2020ATS_6807;
The object of this clinical case report is to highlight an important side effect that can be detrimental in this patient population.Description of case reportA 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.During her extended hospitalization, a rapid response was called for acute encephalopathy concerning for nonconvulsive status epilepticus...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.
ST Segment Changes in Hyperthermia; Infarct or Fiction? (PENNSYLVANIA CONVENTION CENTER, Hall D-E (200 Level), Area K) - Mar 15, 2020 - Abstract #ATS2020ATS_6801;
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.
Paroxysmal Sympathetic Hyperactivity in Glioblastoma Multiforme (PENNSYLVANIA CONVENTION CENTER, Hall D-E (200 Level), Area G) - Mar 15, 2020 - Abstract #ATS2020ATS_5440;
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.
- |||||||||| Decadron (dexamethasone) / Merck (MSD)
A Rare Case of Myeloid Sarcoma Presenting as Acute Cerebrovascular Accident (PENNSYLVANIA CONVENTION CENTER, Hall D-E (200 Level), Area G) - Mar 15, 2020 - Abstract #ATS2020ATS_5436;
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.
Unusual Trigger and Presentation of Neuroleptic Malignant Syndrome (PENNSYLVANIA CONVENTION CENTER, Hall D-E (200 Level), Area G) - Mar 15, 2020 - Abstract #ATS2020ATS_5411;
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, ketamine / Generic mfg., levetiracetam / Generic mfg.
Baclofen Overdose Associated with Prolonged Super-Refractory Status Epilepticus (PENNSYLVANIA CONVENTION CENTER, Hall D-E (200 Level), Area G) - Mar 15, 2020 - Abstract #ATS2020ATS_5409;
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
Lacosamide and Metoprolol: An Uncommon Yet Potentially Deadly Combination (PENNSYLVANIA CONVENTION CENTER, Hall D-E (200 Level), Area G) - Mar 15, 2020 - Abstract #ATS2020ATS_5403;
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.
Do Not Throw in the Towel Too Soon: A Rare Case of Neurotoxicity Due to Alpha-Cypermethrin Toxicity (PENNSYLVANIA CONVENTION CENTER, Hall D-E (200 Level), Area G) - Mar 15, 2020 - Abstract #ATS2020ATS_5399;
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.
A Fatal Case of Valproic Acid-Induced Cerebral Edema (PENNSYLVANIA CONVENTION CENTER, Hall D-E (200 Level), Area G) - Mar 15, 2020 - Abstract #ATS2020ATS_5385;
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
Blocking the Wrong Channel - Bradyasystolic Arrest Following Fosphenytoin Infusion (PENNSYLVANIA CONVENTION CENTER, Hall D-E (200 Level), Area G) - Mar 15, 2020 - Abstract #ATS2020ATS_5377;
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.
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