Levetiracetam nervous system

Nervous system The effects of lamotrigine (n=29), levetiracetam (n = 38), and pheno-barbital (n=28) have been evaluated in patients with seizures and Alzheimer s disease in a prospective, randomized, three-arm parallel-group, case-control study with a 4-week dosage adjustment and a 12-month evaluation period [180. The adverse reactions were somnolence (30%) and weakness (13%). Patients treated with lamotrigine showed a slight decline in Mini Mental Test scores and other cognitive scores and scored better on measures of mood. 

Nervous system In a retrospective analysis of 207 patients treated with levetiracetam, there was a paradoxical increase in seizure frequency or more severe seizures, including generalized tonic-clonic seizures, in 14% of patients [186 ]. Of the 30 patients in the paradoxical effect group, 15 were mentally retarded compared with a much lower percentage of mentally retarded patients in the rest of the group (16/177 = 9%). 

Once-daily adjunctive extended-release levetiracetam 1000 mg/day (n = 70) and adjunctive immediate-release levetiracetam 500 mg bd (n = 204) have been compared in a meta-analysis of three randomized, pla-cebo-controUed, phase III trials in 555 patients aged over 16 years with partial-onset seizures [205 ]. After adjustment for placebo-associated adverse events, immediate-release levetiracetam was associated with statistically more treatment-emergent adverse effects than extended-release levetiracetam across nervous system disorders (risk difference = 18%), psychiatric disorders (risk difference = 11%), and... 

Nervous system Three children with myoclonic seizures were reported to have worsening of their seizures after being started on levetiracetam. All became seizure-free upon withdrawal of levetiracetam and addition of an alternative AED [92 ]. While other antiepileptic medications are known to aggravate generalized seizures, levetiracetam is not typically thought of as one of these medications. 

Nervous system A 50-year-old woman with metastatic colon cancer presented with refractory generalised tonic-clonic seizures 3 weeks posttreatment with FOLFIRI and bevacizumab. The patient became seizure-free on antiepileptic therapy of levetiracetam and phenytoin but lost consciousness, became hypotensive and died following cardiac arrest. Reversible posterior leucoencephalopathy syndrome did not accord with the patient s clinical picture and it is speculated that the mechanism of the promotion pf seizures by bevacizumab in this case may have been due to blood-brain barrier damage [99 ]. 

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See also in sourсe #XX -- [ ]

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