Abstracts

Rationale: Eyelid Myoclonia with Absences syndrome (EMA) has become increasingly recognized over recent years. EMA patients may be resistant to the conventional antiepileptic drugs (AEDs). We assessed the efficacy and tolerability of levetiracetam in our EMA patients.Methods: A retrospective study was performed on EMA patients investigated by means of video-EEG who received levetiracetam. Diagnosis was based on strict criteria as suggested by Italian League Against Epilepsy, i.e., eyelid myoclonia with or without absences, eye closure-induced seizures, EEG paroxysms or both, and photosensitivity. Fifteen patients were reviewed (9 female), with a mean age of 22.5 years (range 14-42). Levetiracetam was administered at the dose of 500 mg twice per day up to the target dose of 50 mg/kg/day. It was given as add-on in 13 patients and as monotherapy in 2 at median dose of 2000 mg/day (range 1500-3500). Co-medication were valproate in 9 patients and phenobarbital in 4. The mean monthly frequency of days with absences (DWA) and of generalized tonic-clonic seizures (GTCS) were considered as endpoints. Results: Four out of 12 (33.3%) were seizure-free and the mean monthly frequency of DWA and of GTCS were reduced >50% in 5/12 (41.6%) patients. Furthermore, EEG abnormalities and photosensitivity were also improved in most cases. The most common adverse effect was somnolence occurring in five patients including 3 drop outs in co-therapy with phenobarbital (2) or valproate (1). The mean follow-up was 24 (range 8-30) months.Conclusions: Levetiracetam was effective and well tolerated in our series and may be reasonable alternative to conventional AEDs in EMA. Furthermore, our findings confirms the broad clinical spectrum of levetiracetam.