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.
Original language | English |
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Pages (from-to) | 425-430 |
Number of pages | 6 |
Journal | Epilepsia |
Volume | 49 |
Issue number | 3 |
DOIs | |
Publication status | Published - Mar 2008 |
Keywords
- AEDs
- EMA
- Epilepsy
- Jeavons syndrome
- Levetiracetam
ASJC Scopus subject areas
- Clinical Neurology
- Neuroscience(all)