levetiracetam and Nervous-System-Diseases

The role of levetiracetam in different epileptic, nonepileptic, neurologic, and psychiatric disorders is discussed.. Levetiracetam, an antiepileptic drug (AED), was first approved as an adjunctive therapy for the treatment of partial epilepsy in adults. It is currently being used in the treatment of multiple seizure disorders, including generalized tonic-clonic; absence; myoclonic, especially juvenile myoclonic; Lennox-Gastaut syndrome; and refractory epilepsy in children and adults. Data are emerging on possible uses of levetiracetam outside the realm of epilepsy because of its unique mechanisms of action. There is preliminary evidence about the efficacy of levetiracetam in the treatment of different psychiatric disorders, including anxiety, panic, stress, mood and bipolar, autism, and Tourette's syndrome. The most serious adverse effects associated with levetiracetam use are behavioral in nature and might be more common in patients with a history of psychiatric and neurobehavioral problems.. Levetiracetam is an effective AED with potential benefits in other neurologic and psychiatric disorders. The benefit-risk ratio in an individual patient with a specific condition should be used to determine its optimal use. Levetiracetam's use in nonepileptic conditions is not recommended until more data become available from larger trials.

Topics: Anticonvulsants; Humans; Levetiracetam; Mental Disorders; Nervous System Diseases; Piracetam

Topics: Adrenal Cortex Hormones; Adult; Aged; Antibodies, Monoclonal, Humanized; Biological Products; Biomarkers; Cyclophosphamide; Cytokine Release Syndrome; Drug Therapy, Combination; Female; Humans; Immunotherapy, Adoptive; Leukapheresis; Levetiracetam; Lymphoma, Large B-Cell, Diffuse; Male; Middle Aged; Nervous System Diseases; Neutropenia; Propensity Score; Vidarabine; Young Adult

Brain metastases originate from other primary cancers within the body, most commonly lung, breast, and melanoma. Because patients with brain metastasis, stroke, or intracranial hemorrhage may present with similar acute neurologic symptoms, clinicians must have a high suspicion for brain metastasis and perform an immediate workup to rule out life-threatening conditions. This case report focuses on the clinical symptoms, diagnostics, and treatment options for brain metastasis in a patient with multiple malignancies.

Topics: Brain Neoplasms; Cranial Irradiation; Dexamethasone; Esophageal Neoplasms; Humans; Levetiracetam; Magnetic Resonance Imaging; Male; Melanoma; Neoplasms, Multiple Primary; Nervous System Diseases; Prostatic Neoplasms; Radiosurgery; Scalp; Seizures; Skin Neoplasms; Tomography, X-Ray Computed

Topics: Anticonvulsants; Brain Injuries, Traumatic; Humans; Incidence; Levetiracetam; Nervous System Diseases; Phenytoin; Retrospective Studies; Seizures

We tested the impact of antiepileptic drug (AED) administration on post-cardiac arrest epileptiform electroencephalographic (EEG) activity.. We studied an observational cohort of comatose subjects treated at a single academic medical center after cardiac arrest from September 2010 to January 2018. We aggregated the observed EEG patterns into 5 categories: suppressed; discontinuous background with superimposed epileptiform activity; discontinuous background without epileptiform features; continuous background with epileptiform activity; and continuous background without epileptiform activity. We calculated overall probabilities of transitions between EEG states in a multistate model, then used Aalen's additive regression to test if AEDs or hypothermia are associated with a change in these probabilities.. Overall, 828 subjects had EEG-monitoring for 42,840 h with a median of 40 [IQR 23-64] h per subject. Among patients with epileptiform findings on initial monitoring, 50% transitioned at least once to a non-epileptiform, non-suppressed state. By contrast, 19% with non-epileptiform initial activity transitioned to an epileptiform state at least once. Overall, 568 (78%) patients received at least one AED. Among patients with continuous EEG background activity, valproate, levetiracetam and lower body temperature were each associated with an increased probability of transition from epileptiform states to non-epileptiform states, where patients with discontinuous EEG background activity no agent linked to an increased probability of transitioning from epileptiform states.. After cardiac arrest, the impact of AEDs may depend on the presence of continuous cortical background activity. These data serve to inform experimental work to better define the opportunities to improve neurologic care post-cardiac arrest.

Topics: Anticonvulsants; Cohort Studies; Coma; Combined Modality Therapy; Electroencephalography; Female; Heart Arrest; Humans; Hypothermia, Induced; Hypoxia, Brain; Levetiracetam; Male; Middle Aged; Nervous System Diseases; Outcome and Process Assessment, Health Care; Resuscitation; Seizures; United States; Valproic Acid

Norrie disease is an X-linked recessive disorder that is characterized by congenital blindness. Although epileptic seizures are observed in some patients with Norrie disease, little is known about this phenomenon. Here, we report the manifestation of epilepsy in siblings with Norrie disease to increase our knowledge of epilepsy in this condition. Three brothers with congenital blindness were diagnosed with Norrie disease after genetic analyses indicated the deletion of exon 2 of the NDP gene. The eldest brother had suffered from epileptic seizures since the age of 11years, and his seizures were resistant to antiepileptic drugs. Although the second brother had no epileptic seizures, the youngest sibling had experiences epileptic seizures since the age of 8years. His seizures were controlled using lamotrigine and levetiracetam. An electroencephalography (EEG) revealed epileptiform discharges in the occipital areas in all three brothers. A study of these patients will increase our knowledge of epilepsy in patients with Norrie disease.

Topics: Anticonvulsants; Blindness; Chromosomes, Human, X; Electroencephalography; Epilepsy; Eye Proteins; Genetic Diseases, X-Linked; Humans; Lamotrigine; Levetiracetam; Nerve Tissue Proteins; Nervous System Diseases; Pedigree; Phenotype; Piracetam; Retinal Degeneration; Siblings; Spasms, Infantile; Triazines

We report here two cases of autoimmune encephalitis associated with antibodies against the N-methyl-D-aspartate receptor. The primary cause was an ovarian teratoma in one case. The outcomes were good. The first case was a late diagnosis, despite a typical clinical presentation. The clinical presentation of this disease remains unknown, especially in the intensive care unit. The treatment was recently codified and transformed the prognosis of this encephalitis. The second case was early treated in the course of the disease, due to the experience related to the previous case. In case of unexplained acute or subacute encephalitis or psychiatric-like disorders without prior medical history, the determination of the level of expression of antibodies against the N-methyl-D-aspartate receptors and other antineuroreceptors antibodies can help to identify this diagnosis. The initial picture of the disease, its variability and the unawareness of the recent reports on this encephalitis may lead to a wrong diagnosis and inappropriate management.

Topics: Adrenal Cortex Hormones; Adult; Anticonvulsants; Autoimmune Diseases of the Nervous System; Critical Care; Early Diagnosis; Electroencephalography; Female; Glasgow Coma Scale; Humans; Immunization, Passive; Levetiracetam; Limbic Encephalitis; Magnetic Resonance Imaging; Marijuana Smoking; Mental Disorders; Nervous System Diseases; Ovarian Neoplasms; Piracetam; Receptors, N-Methyl-D-Aspartate; Teratoma; Tomography, X-Ray Computed