Effect of Levetiracetam on Photoparoxysmal Responses (PPR) in the EEG.
Abstract number :
1.069
Submission category :
Year :
2001
Submission ID :
232
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
C. Burrow, Birmingham University Seizure Clinic, Birmingham, United Kingdom; T. Betts, Birmingham University Seizure Clinic, Birmingham, United Kingdom; L. Greenhill, Birmingham University Seizure Clinic, Birmingham, United Kingdom
RATIONALE: Photosensitive epilepsy (PSE) is not uncommon, particularly in adolescence, and is commoner in women. The standard treatment is valproate (or, alternatively, lamotrigine or both together) but not all patients respond : UK physicians are becoming reluctant to prescribe valproate to women with epilepsy of child-bearing potential, because of its known teratogenicity. Lamotrigine, although often able to suppress PPR[scquote]s induced by photo stimulation is, often unsuccessful against PPR[scquote]s induced by pattern stimulation (Burrow, C. Betts, T. Harding, G. et al 2001). Levetiracetam has been shown in a single dose study to be effective against PPR[scquote]s. Might it be an acceptable alternative in resistant PSE? We have analysed the data in those patients in our clinic with resistant PSE treated with levetiracetam.
METHODS: The notes of all patients in our department, treated with levetiracetam, and who were known to be photo or pattern sensitive and resistant to valproate and lamotrigine were examined for evidence of efficacy of levetiracetam against photo/pattern sensitivity.
RESULTS: In the patients so far reviewed, levetiracetam lead to abolition or significant reduction in photically induced PPR[scquote]s in most patients: in those few patients who had resistant pattern induced PPR[scquote]s there was a similar sustained abolition or reduction.
CONCLUSIONS: Although, since most patients with PPR[scquote]s have primary generalised epilepsy, use of levetiracetam in this condition is currently outwith it[scquote]s licensed indications (for which the medically qualified author (TB) takes clinical responsibility) a formal trial of levetiracetam in patients with resistant PPR[scquote]s is clearly indicated.
REFERENCES
Burrow,C. Betts, T, Harding, G et al. The effect of Lamotrigine on photoparoxysmal responses in the EEG, Seizure 2001: 10: to be published.
Disclosure: Grant - Our department has received research funding from UCB Pharma for clinical trials, but not for this study. Consulting - TB is on the UK UCB Pharma advisory board. Materials - nil Honoraria - TB has received occasional honoraria for speaking for UCB Pharma.