Authors :
Presenting Author: Juan jesús Rodríguez Uranga, MD, PhD – ADVANCE NEUROLOGY CENTER
juan María Sánchez Caro, PhD – Neurologist, Neurology, ADVANCE NEUROLOGY CENTER; Rosham Hariramari Ramchandani, PhD – Neurologist, Neurology, ADVANCE NEUROLOGY CENTER; iratxe Maestro Saiz, PhD – Neurophisiologist, Neurology, ADVANCE NEUROLOGY CENTER
Rationale:
In this study we provide our experience as a refractory epilepsy unit in a real-world practice on optimizing CNB efficacy and minimizing adverse effects by rapidly reducing co-medications.
Methods:
We performed a prospective observational study of patients with focal DRE treated with CNB in our clinic.
Results:
A total of 34 patients were included. Twenty-one patients had reached 12 months of follow up by December 2022. Mean CNB dose (mg) was 207.8 (SD 25.7), 267.2 (SD 53.9), and 326.2 (SD 80) at three, six, and twelve months of follow up, respectively. Seven patients discontinued treatment (six due to inefficacy and one due to ataxia).
Median seizure reduction was 93.3% at six months and 88.9% at 12 months of follow-up. Response rate ( >50% seizure reduction) was 85.7% at 12 months. Responder rate >90% was achieved by 10 patients (47.6%) at 12 months. Seven patients (33.3%) were seizure-free at 12 months. PGI-I, including discontinued patients, was very much better/much better in 14 patients (41.2%), a little better in eight patients (23.5%), no change in six patients (17.6%) and much worse/very much worse in six patients (17.6%) of patients.
The total defined daily dose (DDD) of co-administered anti-seizure drugs decreased significantly during follow-up (mean 3.6 DDD, SD 1.3 at baseline; mean 1.4 DDD, SD 1.2 at 12 months of follow-up; p< 0001). Adverse effects were frequent initially (35.3% ataxia, 52.9% dizziness and 64.7% drowsiness) but were drastically reduced at 12 months (3.8% ataxia, no dizziness and 33.3% drowsiness at 12 months). No skin rash was detected.