Objective: Eyelid myoclonia with absences (EMA) or Jeavons syndrome characterized by eyelid myoclonia (EM) (with or without absences), eye closure-induced EEG paroxysms, and photosensitivity. We conducted an open-label trial of levetiracetam in EMA. Patients and Methods: Patients were recruited in different Italian Epilepsy Centres. Levetiracetam was administrated at starting dose of 10 mg/kg/day up to 50-60 mg/kg/day in two doses. Treatment period included a 5-6 week up-titration phase and a 12-week evaluation phase. The number of days with EM (i.e., days with seizures, DwS) and number of generalized tonic-clonic seizures (GTCS) were evaluated. Analysis of intent-to-treat population was performed using Fisher's and Wilcoxon tests. Results: Thirty-five patients (23 F) with a mean age of 19 +/- 6 years were recruited. Twenty-seven had previously undergone one to five adequate trials of antiepileptic drugs. The median number of DwS/month was 12 +/- 8.2. Twenty-one patients experienced GTCS (median number/month: 1 +/- 0.2). Thirty-four subjects completed the trial. Levetiracetam was well tolerated (mean dose: 1985 mg/day). Responders were 28/35 (80%) patients, nine taking levetiracetam as monotherapy. Six patients were seizure-free, 15 had >= 75% and seven > 50% seizure reduction. GTCS remitted in 14 out of 21 (66.6%) patients. The number/month of DwS (median: 12 vs 5; p = 0.0001) and of GTCS (median: 1 vs 0; p = 0.0001) decreased compared to baseline period. Disappearance or clear reduction in paroxysmal abnormalities at eye closure occurred in 20 of the responders and photoparoxysmal response in 19. Mean follow-up was 23.9 +/- 18.5 months. Conclusion: Levetiracetam is effective and well tolerated in EMA. Placebo-controlled studies should confirm these findings.

A pilot trial of levetiracetam in eyelid myoclonia with absences (Jeavons syndrome) / Pasquale, Striano; Vito, Sofia; Giuseppe, Capovilla; Guido, Rubboli; Carlo Di, Bonaventura; Antonietta, Coppola; Giuseppina, Vitale; Luis, Fontanillas; Giallonardo, Anna Teresa; Roberto, Biondi; Antonino, Romeo; Maurizio, Viri; Federico, Zara; Salvatore, Striano. - In: EPILEPSIA. - ISSN 0013-9580. - 49:3(2008), pp. 425-430. [10.1111/j.1528-1167.2007.01524.x]

A pilot trial of levetiracetam in eyelid myoclonia with absences (Jeavons syndrome)

GIALLONARDO, Anna Teresa;
2008

Abstract

Objective: Eyelid myoclonia with absences (EMA) or Jeavons syndrome characterized by eyelid myoclonia (EM) (with or without absences), eye closure-induced EEG paroxysms, and photosensitivity. We conducted an open-label trial of levetiracetam in EMA. Patients and Methods: Patients were recruited in different Italian Epilepsy Centres. Levetiracetam was administrated at starting dose of 10 mg/kg/day up to 50-60 mg/kg/day in two doses. Treatment period included a 5-6 week up-titration phase and a 12-week evaluation phase. The number of days with EM (i.e., days with seizures, DwS) and number of generalized tonic-clonic seizures (GTCS) were evaluated. Analysis of intent-to-treat population was performed using Fisher's and Wilcoxon tests. Results: Thirty-five patients (23 F) with a mean age of 19 +/- 6 years were recruited. Twenty-seven had previously undergone one to five adequate trials of antiepileptic drugs. The median number of DwS/month was 12 +/- 8.2. Twenty-one patients experienced GTCS (median number/month: 1 +/- 0.2). Thirty-four subjects completed the trial. Levetiracetam was well tolerated (mean dose: 1985 mg/day). Responders were 28/35 (80%) patients, nine taking levetiracetam as monotherapy. Six patients were seizure-free, 15 had >= 75% and seven > 50% seizure reduction. GTCS remitted in 14 out of 21 (66.6%) patients. The number/month of DwS (median: 12 vs 5; p = 0.0001) and of GTCS (median: 1 vs 0; p = 0.0001) decreased compared to baseline period. Disappearance or clear reduction in paroxysmal abnormalities at eye closure occurred in 20 of the responders and photoparoxysmal response in 19. Mean follow-up was 23.9 +/- 18.5 months. Conclusion: Levetiracetam is effective and well tolerated in EMA. Placebo-controlled studies should confirm these findings.
2008
aeds; ema; epilepsy; jeavons syndrome; levetiracetam
01 Pubblicazione su rivista::01a Articolo in rivista
A pilot trial of levetiracetam in eyelid myoclonia with absences (Jeavons syndrome) / Pasquale, Striano; Vito, Sofia; Giuseppe, Capovilla; Guido, Rubboli; Carlo Di, Bonaventura; Antonietta, Coppola; Giuseppina, Vitale; Luis, Fontanillas; Giallonardo, Anna Teresa; Roberto, Biondi; Antonino, Romeo; Maurizio, Viri; Federico, Zara; Salvatore, Striano. - In: EPILEPSIA. - ISSN 0013-9580. - 49:3(2008), pp. 425-430. [10.1111/j.1528-1167.2007.01524.x]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/117434
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