Abstracts

Rationale: A significant number of patients with Idiopathic Generalized Epilepsies (IGE) do not respond or present intolerable adverse events to the antiepileptic drugs (AEDs) approved for IGE. Brivaracetam is a new AED that has demonstrated to be effective in experimental models of IGE.We aim to describe the real-life clinical experience of brivaracetam in patients with IGE that present inadequate epilepsy control or adverse events with other AEDs. Methods: We retrospectively collected =16 year-old patients who met clinical and EEG criteria for IGE in which brivaracetam was started, and completed a follow-up period =6 months. We analyzed clinical features as well as EEG background and interictal epileptiform discharges. Results: We recruited 30 patients: 70% women; mean age 29.9 (±12.2) years. IGE syndromes: Juvenile myoclonic epilepsy (47%); IGE with generalized tonic-clonic seizures only (30%); Myoclonic absences (13%) and Juvenile absence epilepsy (10%). The main reason to start brivaracetam was lack of efficacy (57%) or adverse events (33%) of previous AEDs, and childbearing potential (10%). Brivaracetam monotherapy was used in 27% and valproate was the most common AED combined in polytherapy. Brivaracetam daily doses ranged between 50 mg and 300 mg, with 100 mg (33%) and 200 mg (30%) the most likely used. Nearly 60% of patients were considered responders and 50% achieved seizure freedom. Adverse events, commonly associated with the drug class, were reported in 33%. No serious adverse events were recorded. Discontinuations were observed in 33%, due to lack of response or presence of adverse events. The EEG showed no significant background modifications and a trend to modify the frequency of the interictal epileptiform discharges, probably in line with the seizure frequency. Conclusions: Brivaracetam can be a safe alternative in adult patients with difficulties to control IGEs. Funding: None