- |||||||||| Vimpat (lacosamide) / UCB, Daiichi Sankyo, levetiracetam / Generic mfg.
Outcome of Epilepsy in Older Adults; Preliminary Analysis () - Jan 21, 2020 - Abstract #AAN2020AAN_1740;
Levetiracetam, Lamotrigine and Lacosamide were the most commonly utilized ASDs in the elderly patients. Lamotrigine monotherapy was most often associated with seizure free state.
- |||||||||| Fycompa (perampanel) / Eisai
Adjunctive Perampanel in Refractory Status Epilepticus (RSE): A Report of Two Cases. () - Jan 21, 2020 - Abstract #AAN2020AAN_1695;
Both our patients with RSE were successfully weaned off the anesthetic drug with introduction of Perampanel. The use of Perampanel in this manner deserves further study to determine its efficacy and safety, more quantitatively as an adjunctive therapy for RSE.
- |||||||||| Fycompa (perampanel) / Eisai
Perampanel associated with developmental regression in patient with FRRS1L mutation () - Jan 21, 2020 - Abstract #AAN2020AAN_1684;
We present a case of novel mutation in FRRS1L associated with epilepsy and hypotonia in which developmental regression was associated with initiation of perampanel. Further research is needed to understand the effects of perampanel on this type of AMPA receptor mutations.
- |||||||||| Vimpat (lacosamide) / UCB, Daiichi Sankyo, levetiracetam / Generic mfg.
Infant presenting with Autoimmune NMDA Positive encephalitis secondary to Herpes Simplex Encephalitis: A Case Report () - Jan 21, 2020 - Abstract #AAN2020AAN_1206;
Movement disorders in infants are difficult to diagnose, overlapping symptoms from seizures or cerebral palsy can make it further difficult. Relapsing symptoms post herpes simplex virus encephalitis should raise a high clinical suspicion of anti-NMDA receptor encephalitis and clinicians should be cautious as this condition can often be misdiagnosed in infants.
- |||||||||| lamotrigine liquid oral suspension / OWP Pharma
Behavioral Complications from Levetiracetam in the Epilepsy Monitoring Unit () - Jan 21, 2020 - Abstract #AAN2020AAN_887;
LEV was transitioned mostly commonly to lamotrigine (43.2%) in our population. We recommend counseling patients regarding behavioral side effects and prompt follow-up when side effects are noted.
- |||||||||| lacosamide / Generic mfg.
Journal: Phosphorylated CRMP2 Regulates Spinal Nociceptive Neurotransmission. (Pubmed Central) - Jan 17, 2020
The presynaptic nature of CRMP2's actions was further confirmed by pharmacological antagonism of Cdk5-mediated CRMP2 phosphorylation with S-N-benzy-2-acetamido-3-methoxypropionamide ((S)-lacosamide; (S)-LCM) which (i) decreased sEPSC frequency, (ii) increased paired-pulse ratio, and (iii) reduced the presynaptic distribution of CaV2.2 and NaV1.7, two voltage-gated ion channels implicated in nociceptive signaling...Together, these findings indicate that CRMP2 regulates presynaptic excitatory neurotransmission in spinal cord and may play an important role in regulating pathological pain. Novel targeting strategies to inhibit CRMP2 phosphorylation by Cdk5 may have great potential for the treatment of chronic pain.
- |||||||||| Decadron (dexamethasone) / Merck (MSD), Trileptal (oxcarbazepine) / Novartis
Journal: Abdominal epilepsia partialis continua in neurocysticercosis. (Pubmed Central) - Jan 4, 2020
The involvement of the primary motor cortex during ictal propagation may account for this curious phenomenon. This is the first report of abdominal EPC in a patient with inflammatory granuloma as a result of neurocysticercosis.
- |||||||||| lacosamide / Generic mfg.
Trial completion date, Trial primary completion date: Lacosamide Effects on Alcohol Self Administration and Craving in Heavy Drinkers (clinicaltrials.gov) - Jan 2, 2020
P1, N=28, Recruiting,
This is the first report of abdominal EPC in a patient with inflammatory granuloma as a result of neurocysticercosis. Trial completion date: Dec 2019 --> Aug 2020 | Trial primary completion date: Dec 2019 --> Aug 2020
- |||||||||| lacosamide / Generic mfg., levetiracetam / Generic mfg., Cerebyx (fosphenytoin) / Pfizer, Nobelpharma
Retrospective data, Journal, HEOR: Meta-analysis and cost-effectiveness of second-line antiepileptic drugs for status epilepticus. (Pubmed Central) - Jan 1, 2020
VPA and PB were more effective than PHT for SE. There is substantial overlap in the cost-effectiveness of non-BZD AEDs for SE, but available evidence does not support the preeminence of PHT, neither in terms of effectiveness nor in terms of cost-effectiveness.
- |||||||||| pregabalin / Generic mfg., Trileptal (oxcarbazepine) / Novartis
Journal: Update on Antiepileptic Drugs 2019. (Pubmed Central) - Dec 20, 2019
An increasingly recognized etiology of status epilepticus is autoimmune encephalitis, which may not be as rare as previously thought. Knowledge of AED pharmacokinetics, efficacy, and tolerability profiles facilitates the choice of appropriate AED therapy for patients with epilepsy.
- |||||||||| lacosamide / Generic mfg.
Preclinical, Journal: Neuroprotective Effects of Lacosamide in Experimental Traumatic Spinal Cord Injury in Rats. (Pubmed Central) - Dec 20, 2019
Knowledge of AED pharmacokinetics, efficacy, and tolerability profiles facilitates the choice of appropriate AED therapy for patients with epilepsy. Lacosamide has a neuroprotective effect in SCI in rats that is related to its ability to decrease the production of reactive oxygen species by increasing antioxidant enzyme expression, inhibit lipid peroxidation and attenuate glial cell activation.
- |||||||||| lacosamide / Generic Mfg.
Retrospective data, Journal: Status epilepticus management and mortality risk factors: A retrospective study. (Pubmed Central) - Nov 29, 2019
This neuroprotective capacity depends on its scavenger role for free oxygen radicals by increasing antioxidant enzyme activity. To improve SE management and reduce mortality rates, training activities targeting emergency department physicians should be implemented, together with elective intensive care admission for patients with multiple mortality risk factors (eg, absence of history of epilepsy, acute stroke, or cardiovascular complications).
- |||||||||| Trileptal (oxcarbazepine) / Novartis
Awareness of Seizures: Patient Report and RNS Record (Hall E) - Nov 28, 2019 - Abstract #AES2019AES_1515;
It can also be challenging to differentiate focal seizures without awareness from non-epileptic hypervigilant behaviors by patients’ descriptions. RNS ECog recordings provide further objective electrophysiological evidence, and therefore could be helpful in the diagnosis and treatment.
- |||||||||| lacosamide / Generic mfg.
Efficacy and Usefulness of Lacosamide Monotherapy for Patients with Epilepsy (Hall E) - Nov 28, 2019 - Abstract #AES2019AES_1381;
More patients became free from seizures in Group A as compared to that in Group B, because patients in Group A were treated earlier from the diagnosis of epilepsy. Therefore LCM could be used as one of the first line AEDs especially for patients with newly diagnosed epilepsy.
- |||||||||| lacosamide / Generic mfg., levetiracetam / Generic mfg.
Utility of Inpatient Brain MRI and EEG for New-Onset Seizures: A Five-Year Single Hospital Experience (Hall E) - Nov 28, 2019 - Abstract #AES2019AES_1361;
Conclustions At our institution, patients presenting with new-onset seizure and a normal neurologic exam typically have additional testing such as MRI brain and EEG as an outpatient, whereas those who present with an abnormal neurologic exam often have these tests done on an inpatient basis. This retrospective chart review of the utility of such testing in the inpatient setting supports the continued practice of obtaining these tests when deemed necessary by a neurologist as they frequently led to a change in acute management or an anticipated change in future outpatient management.
- |||||||||| lacosamide / Generic mfg., levetiracetam / Generic mfg.
Analysis of the Time to Follow Up After Status Epilepticus: A Retrospective Cohort Study (Hall E) - Nov 28, 2019 - Abstract #AES2019AES_1357;
Patients who did follow up in the outpatient were refractory with monthly seizures on an average of two medications. Those who had a shorter latency to their outpatient visits had a significantly lower average number of seizures which underlines the importance of continued care after the resolution of status epilepticus.
- |||||||||| carbamazepine / Generic mfg., Trileptal (oxcarbazepine) / Novartis
Antiepileptic Drug Use and Pregnancy Outcomes in African American Women with Epilepsy (Hall E) - Nov 28, 2019 - Abstract #AES2019AES_1164;
The other AEDs used were oxcarbazepine (OXC) and phenytoin (PHT)...The only major congenital malformation (carbamazepine) in the cohort also occurred in an AA woman taking carbamazepine...Despite the overall safety profile of newer AEDs reported in national registries, our cohort of mostly AA WWE showed slightly more adverse pregnancy and fetal outcomes which could be due to the low use of pre-conception folic acid use and higher incidence of unplanned pregnancies. Medical provider and patient education is essential in planning pregnancies and prescribing folic acid as AA WWE may be exposed to slightly higher risks of complications in pregnancy than reported in existing national registries.
- |||||||||| pregabalin / Generic mfg., carbamazepine / Generic mfg., Trileptal (oxcarbazepine) / Novartis
Levetiracetam Versus Sodium Channel Blockers as First Prescribed Antiepileptic Drug: Data from the Human Epilepsy Project (Hall E) - Nov 28, 2019 - Abstract #AES2019AES_1095;
Results 157 (59.5%) initiated levetiracetam (LEV), 49 (18.6%) lamotrigine (LTG), 21 (8%) oxcarbazepine (OXC), 11 (4.2%) phenytoin, 5 (1.9%) topiramate, 12 (4.5%) carbamazepine, (CBZ) 2 (0.8%) lacosamide, 5 (1.9%) valproic acid, 1 (0.4%) pregabalin, and 1 (0.4%) zonisamide.Of the 157 started on LEV, 63 (31.6%) remained on the drug in monotherapy, 76 (48%) switched to another AED, 12 (7.6%) added an AED in conjunction, and 6 (3.8%) ceased AED usage...By the end of the study, pts were receiving the following AEDs alone or in combination: LEV 36.0%, LTG 37.5%, CBZ 6.8%, OXC 17.0%, PHT 0.8%, topiramate 2.3%, lacosamide 7.2%, valproic acid 1.9%, zonisamide 4.9%, lorazepam 0.8%, clobazam 0.4%, clonazepam 0.4%...The likelihood of remaining on initial monotherapy was twice as high for a sodium channel blocker as for LEV in the first 2 years of treatment. (P=.001)
- |||||||||| lacosamide / Generic mfg., levetiracetam / Generic mfg., levetiracetam low dose (AGB101) / AgeneBio
Second-Line Anti-Seizure Medication Dosing in Pediatric Refractory Convulsive Status Epilepticus (Hall E) - Nov 28, 2019 - Abstract #AES2019AES_959;
If a patient was > 50kg, we considered 1000mg as the minimum dose (for all ASM, except for lacosamide –LAC-)...Reasons of dividing doses may include medical concerns related to clinical presentation or potential side effects. At times, treatment times exceeded optimal medication application, and analysis of factors related to treatment timing is ongoing to tailor respective interventions.
- |||||||||| lacosamide / Generic mfg., levetiracetam / Generic mfg., acyclovir / Generic mfg.
Cotard’s Syndrome: An Uncommon Presentation of Postictal Psychosis (Hall E) - Nov 28, 2019 - Abstract #AES2019AES_860;
High serum concentrations of CMMG (carboxymethoxymethylguanine), the principal metabolite of acyclovir, have been associated with Cotard’s delusions, nevertheless, this often seen in patients with renal disease. There is no specific treatment for Cotard’s syndrome; the general approach for treatment involves treating the underlying medical or neuropsychiatric illness in all cases.
- |||||||||| carbamazepine / Generic mfg., Trileptal (oxcarbazepine) / Novartis
Risk of Epileptic Spasms Induction by Voltage-Gated Sodium Channel Blockade (Hall E) - Nov 28, 2019 - Abstract #AES2019AES_858;
Several case reports have suggested that voltage-gated sodium channel blockade by carbamazepine (CBZ) or oxcarbazepine (OXC) may induce epileptic spasms (Mutoh 1993; Veerapandiyan 2012)...Cox proportional hazards regression, with time-varying covariates to account for dynamic exposure to specific anti-seizure drugs, was used to determine whether time to onset of ES was associated with exposure to any voltage-gated sodium channel blocker, namely CBZ, OXC, lacosamide (LAC), and phenytoin (PHT)...However, these results should be interpreted in the context of the limitations of the study design-especially the lack of randomization. Further study is warranted.
- |||||||||| Epilepsy and Multiple Sclerosis: A Single Institutional Experience (Hall E) - Nov 28, 2019 - Abstract #AES2019AES_821;
It seems that an increased degree of surveillance and awareness of seizure risk will benefit the standard of care as patients develop more active, advanced, or longstanding MS disease. In our patient cohort, less than half of the patients were seizure free, and most were taking second generation AED rather than first generation AED.
- |||||||||| lacosamide / Generic mfg., lorazepam / Generic mfg., levetiracetam / Generic mfg.
An Unusual Case of Subacute Encephalopathy with Seizures in Alcoholics (SESA) Syndrome (Hall E) - Nov 28, 2019 - Abstract #AES2019AES_815;
He was given intravenous (IV) lorazepam and levetiracetam which resulted in cessation of clinical seizure activity, however he remained poorly responsive and unable to follow commands...He was continued on levetiracetam, lacosamide and valproic acid and was discharged to a rehabilitation facility...The evolution into super-refractory NCSE makes this case particularly unusual and highlights the importance of continuous EEG monitoring in this condition. Unlike alcohol withdrawal seizures, SESA syndrome typically requires chronic treatment with AEDs as recurrence is common.
- |||||||||| lacosamide / Generic mfg., lamotrigine liquid oral suspension / OWP Pharma
Ultra Long-Term EEG as an Improvement over Seizure Diary When Optimizing AED Treatment (Hall E) - Nov 28, 2019 - Abstract #AES2019AES_746;
It is a minimally invasive method, which accommodates the possibility of unobtrusive recordings in the every-day life of epilepsy patients. Further, based on this case-study, it is likely that ultra long-term EEG increases the power of clinical trials in epilepsy due to a more correct seizure count than has previously been available.
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