AIM: To review the clinical response to levetiracetam(LEV) in neonatal seizure management in intensive care unit.METHODS: Medical records of neonates who received LEV from January 2009 to August 2014 were reviewed. Th...AIM: To review the clinical response to levetiracetam(LEV) in neonatal seizure management in intensive care unit.METHODS: Medical records of neonates who received LEV from January 2009 to August 2014 were reviewed. Their demographic data, clinical characteristics, etiology, seizures, electroencephalograms, response to treatment and outcome were noted. Literature review of use of LEV in neonates were also performed via Pub Med and EMBASE with keywords- "neonates", "seizures", "epilepsy" and "LEV" up to Sep 2014 and retrieved the publications. The response rate to LEV was compared.RESULTS: Twelve neonates were identified during the study period. All patients received phenobarbitone loading prior to consideration of LEV. Seven(58%) and nine(75%) achieved seizure freedom 24 h and 72 h after LEV was added, both clinically and electrographically. No serious adverse effects were associated with LEV use. From the literature, there are total 144 neonates reported to have used LEV. The overall results suggested that LEV could control up to 90% of neonatal seizures.CONCLUSION: LEV was found to be relatively safe and efficacious in treating neonatal seizures, but might not work well in the most severe hypoxic ischemic encephalopathy.展开更多
This case report investigates an uncommon occurrence of drug induced acute liver injury directly associated with the administration of levetiracetam in a patient following traumatic brain injury.
Tyrosine kinase receptor B （TrkB） plays an important role in long-term potentiation and memory formation.The present study used all-trans retinoic acid to induce TrkB expression in SH-SY5Y cells,and observed the eff...Tyrosine kinase receptor B （TrkB） plays an important role in long-term potentiation and memory formation.The present study used all-trans retinoic acid to induce TrkB expression in SH-SY5Y cells,and observed the effects of levetiracetam （LEV） on TrkB expression.Following exposure to 10,50,and 100 μg/mL LEV,the number of TrkB-positive cells,and average absorbance value were increased.Results demonstrated that LEV can induce TrkB expression in SH-SY5Y cells.展开更多
DRESS syndrome is a severe drug induced reaction. Acute kidney injury (AKI) is sometimes present in the form of an acute interstitial nephritis. We present the case of a 75-year-old man with glioblastoma who developed...DRESS syndrome is a severe drug induced reaction. Acute kidney injury (AKI) is sometimes present in the form of an acute interstitial nephritis. We present the case of a 75-year-old man with glioblastoma who developed a DRESS two months after starting levetiracetam and a few days after stopping dexamethasone. His skin and kidneys improved after removing levetiracetam and introducing again corticosteroids. DRESS has been reported more frequently with other antiepileptics, rarely with levetiracetam. Clinicians should add this drug to the list of potential causes of AKI.展开更多
Objective:To study the influence of adjuvant levetiracetam therapy on serum nerve cytokines and apoptosis molecules in patients with refractory partial epileptic seizure.Methods: A total of 92 patients with refractory...Objective:To study the influence of adjuvant levetiracetam therapy on serum nerve cytokines and apoptosis molecules in patients with refractory partial epileptic seizure.Methods: A total of 92 patients with refractory partial epileptic seizure treated in our hospital between July 2012 and January 2016 were divided into control group (n=46) and observation group (n=46) according to random number table. Patients in the control group were treated with routine treatment, those in observation group were treated with routine treatment plus adjuvant levetiracetam therapy, and the treatment lasted for 20 weeks. Serum contents of nerve cytokines and apoptosis molecules were compared between two groups before and after treatment.Results:Before treatment, differences in serum levels of nerve injury indexes, nerve protection indexes, monoamine neurotransmitters and apoptosis molecules were not statistically significant between two groups of patients. After treatment, serum contents of nerve injury indexes S-100β, GFAP, NSE and MBP in both groups were significantly lower than those before treatment, contents of nerve protection indexes BDNF and IGF-1 were significantly higher than those before treatment, contents of monoamine neurotransmitters DA, 5-HT and NE were significantly higher than those before treatment, contents of apoptosis molecules Bcl-2, Fas and FasL were significantly lower than those before treatment, and the changes in contents of above indexes in observation group were larger than those in control group.Conclusion:The adjunctive therapy of levetiracetam can reduce the nerve injury in patients with refractory partial epileptic seizure and exert active cerebral protective effect.展开更多
Epilepsy is a common neurological disorder in neurology clinic. Levetiracetam is considered as one of common antiepileptic drugs used to manage epilepsy with good efficacy and tolerability profile. It is renally excre...Epilepsy is a common neurological disorder in neurology clinic. Levetiracetam is considered as one of common antiepileptic drugs used to manage epilepsy with good efficacy and tolerability profile. It is renally excreted and not depending on the cytochrome p450. It has adverse effects reported as somnolence, headaches, dizziness, depression and anxiety. Also, it was reported that levetiracetam can cause Acute kidney injury (AKI), renal profile disturbance, that may be related to its way of excretion and possible nephrotoxicity especially with high loading dose. We are reporting a young female patient with epilepsy presented to hospital with status epileptcus and started on loading dose of levetiracetam 3 grams and then maintenance dose of 1 gram twice daily seizure were controlled but she developed acute kidney injury that improved after discontinue leveriracetam and medical management without renal dialysis and discharged home in stable condition. Physician and health care providers should be aware of such rare adverse reaction and available management options for better patient care and outcome.展开更多
Objective:To explore the effects of sodium valproate combined with levetiracetam in the treatment of children epilepsy,and its influences on serum S-100βand high mobility group box-1(HMGB-1)in children with epilepsy....Objective:To explore the effects of sodium valproate combined with levetiracetam in the treatment of children epilepsy,and its influences on serum S-100βand high mobility group box-1(HMGB-1)in children with epilepsy.Methods:A total of 160 children who were diagnosed as epilepsy in Baogang Hospital of Inner Mongolia from July 2016 to October 2018 were selected as research objects.They were randomly divided into the study group(n=80)and the control group(n=80)by the random number table method,i.e.,they were treated with sodium valproate combined with levetiracetam and sodium valproate alone,respectively.After 16 weeks of treatment,the effective rates of epileptic seizure treatment and the improvement of epileptiform discharge were evaluated,and chi-square test was used for statistical comparison.The related indicators,including serum tumor necrosis factor-(TNF-α),hypersensitive C-reactive protein(hs-CRP),homocysteine(Hcy),haematocrit(HCT),erythrocyte sedimentation rate(ESR),serum S-100βand HMGB-1,were measured before and after treatment.Paired t-test was used for the comparison in the above indicators within a group before and after treatment;group t-test was used for the comparison between two groups.Chi-square test was used for the comparison in the rate of adverse reactions during treatment between two groups.The study was approved by Ethics Committee of Baogang Hospital(Approval No.:BG201606073),and all children’s guardians were required to sign informed consent forms for clinical study.There were no statistically significant differences between two groups in general clinical data(p>0.05),such as sex constituent ratio,age,the course of disease,the frequency of epileptic seizure per year before treatment,the incidence of epileptiform discharge before treatment and the constituent ratio of types of epileptic seizure,etc.Results:1)After treatment,the effective rates of epileptic seizure treatment and the improvement of epileptiform discharge in the study group were 92.5%(74/80)and 85.0%(68/80)respectively,which were both significantly higher than those in the control group[68.8%(55/80)and 58.8%(47/80)],and the differences were statistically significant(Х^(2)=14.444,13.635;p<0.001).2)In the study group,the levels of serum TNF-α,hs-CRP and Hcy,as well as HCT and ESR after treatment were(53.1±14.0)pg/ml,(5.0±2.5)mg/L,(12.5±3.1)μmol/L,(38.1±5.1)%and(3.0±0.5)mm/h respectively,which were all significantly lower than those[(107.9±17.8)pg/ml,(10.1±2.5)mg/L,(42.2±5.8)μmol/L,(45.3±4.5)%and(5.2±0.6)mm/h]before treatment,and all the differences were statistically significant(t=21.644,12.902,40.393,9.468,25.194;p<0.001).In the control group,the levels of serum TNF-α,hs-CRP and Hcy,as well as HCT and ESR after treatment were(60.6±17.8)pg/ml,(8.2±2.2)mg/L,(15.2±3.1)μmol/L,(40.2±3.4)%and(4.5±0.6)mm/h respectively,which were all significantly lower than those[(112.4±14.3)pg/ml,(9.3±3.8)mg/L,(41.1±2.8)μmol/L,(44.6±5.5)%and(5.4±0.8)mm/h]before treatment,and all the differences were statistically significant(t=20.292,2.241,55.456,3.320,8.050;p<0.05).After treatment,the above indicators in the study group were all significantly lower than those in the control group,and all the differences were statistically significant(t=2.962,8.595,5.508,3.064,17.178;p<0.05).3)In the study group,the levels of serum S-100βand HMGB-1 after treatment were(0.65±0.38)μg/L and(5.3±2.4)μg/L respectively,which were significantly lower than those[(0.91±0.32)μg/L and(8.1±2.0)μg/L]before treatment,and the differences were statistically significant(t=4.681,8.020;p<0.001).In the control group,the levels of serum S-100βand HMGB-1 after treatment were(0.78±0.27)μg/L and(6.4±2.2)μg/L respectively,which were significantly lower than those[(0.88±0.25)μg/L and(7.9±1.7)μg/L]before treatment,and the differences were statistically significant(t=2.431,p=.016;t=4.826,p<0.001).After treatment,the levels of serum S-100βand HMGB-1 in the study group were significantly lower than those in the control group,and the differences were statistically significant(t=2.495,p=.014;t=2.840,p=.005).4)There was no significant difference between two groups in the rate of adverse reactions,such as nausea,vomiting,poor appetite,dizziness,drowsiness,hepatic and renal injury during treatment(p>0.05).Conclusions:The efficacy of sodium valproate combined with levetiracetam is obviously better than that of sodium valproate alone in the treatment of children epilepsy.The children patients’serum S-100βand HMGB-1 are more significantly reduced,resulting in a lower rate of adverse reactions,which has a certain clinical value.展开更多
Epilepsy is a common neurological disorder that is primarily treated with antiseizure medications(ASMs).Although dozens of ASMs are available in the clinic,approximately 30%of epileptic patients have medically refract...Epilepsy is a common neurological disorder that is primarily treated with antiseizure medications(ASMs).Although dozens of ASMs are available in the clinic,approximately 30%of epileptic patients have medically refractory seizures;other limitations in most traditional ASMs include poor tolerability and drug-drug interactions.Therefore,there is an urgent need to develop alternative ASMs.Levetiracetam(LEV)is a first-line ASM that is well tolerated,has promising efficacy,and has little drug-drug interaction.Although it is widely accepted that LEV acts through a unique therapeutic target synaptic vesicle protein(SV)2A,the molecular basis of its action remains unknown.Even so,the next-generation SV2A ligands against epilepsy based on the structure of LEV have achieved clinical success.This review highlights the research and development(R&D)process of LEV and its analogs,brivaracetam and padsevonil,to provide ideas and experience for the R&D of novel ASMs.展开更多
Background To compare the preventive effects of levetiracetam and valproate on late-onset post-traumatic seizures in patients with traumatic brain injury(TBI).Methods A total of 95 patients with TBI were recruited fro...Background To compare the preventive effects of levetiracetam and valproate on late-onset post-traumatic seizures in patients with traumatic brain injury(TBI).Methods A total of 95 patients with TBI were recruited from 2017 to 2020.They were randomized into three groups:levetiracetam(LEV)group(n=30)receiving LEV treatment(500 mg,bid,po);valproate group(n=32)receiving sodium valproate(500 mg/d,once daily,po);and control group(n=33)receiving no anti-seizure medication.LEV and valproate were given to corresponding groups within seven days after TBI,and the administration lasted for one month.The incidence of epilepsy and adverse events were evaluated at 7 days and 12 months post-TBI.Results The cumulative incidences of late post-traumatic seizures at the 12-month follow-up in the LEV,valproate,and control groups were 3.33%,12.50%and 15.63%,respectively.The cumulative incidence of late post-traumatic seizures in the LEV group was significantly lower than those in the valproate and control groups(P<0.05).The cumulative incidence of late post-traumatic seizure in the valproate group was not significantly different from that in the control group(P>0.05).Conclusions LEV can reduce the cumulative incidence of late post-traumatic seizures,whereas valproate can not.展开更多
基金Supported by Joint Chinese University of Hong Kong-New Territories East Cluster Clinical Research Ethics Committee(CREC Ref.),No.2014.072
文摘AIM: To review the clinical response to levetiracetam(LEV) in neonatal seizure management in intensive care unit.METHODS: Medical records of neonates who received LEV from January 2009 to August 2014 were reviewed. Their demographic data, clinical characteristics, etiology, seizures, electroencephalograms, response to treatment and outcome were noted. Literature review of use of LEV in neonates were also performed via Pub Med and EMBASE with keywords- "neonates", "seizures", "epilepsy" and "LEV" up to Sep 2014 and retrieved the publications. The response rate to LEV was compared.RESULTS: Twelve neonates were identified during the study period. All patients received phenobarbitone loading prior to consideration of LEV. Seven(58%) and nine(75%) achieved seizure freedom 24 h and 72 h after LEV was added, both clinically and electrographically. No serious adverse effects were associated with LEV use. From the literature, there are total 144 neonates reported to have used LEV. The overall results suggested that LEV could control up to 90% of neonatal seizures.CONCLUSION: LEV was found to be relatively safe and efficacious in treating neonatal seizures, but might not work well in the most severe hypoxic ischemic encephalopathy.
文摘This case report investigates an uncommon occurrence of drug induced acute liver injury directly associated with the administration of levetiracetam in a patient following traumatic brain injury.
文摘Tyrosine kinase receptor B （TrkB） plays an important role in long-term potentiation and memory formation.The present study used all-trans retinoic acid to induce TrkB expression in SH-SY5Y cells,and observed the effects of levetiracetam （LEV） on TrkB expression.Following exposure to 10,50,and 100 μg/mL LEV,the number of TrkB-positive cells,and average absorbance value were increased.Results demonstrated that LEV can induce TrkB expression in SH-SY5Y cells.
文摘DRESS syndrome is a severe drug induced reaction. Acute kidney injury (AKI) is sometimes present in the form of an acute interstitial nephritis. We present the case of a 75-year-old man with glioblastoma who developed a DRESS two months after starting levetiracetam and a few days after stopping dexamethasone. His skin and kidneys improved after removing levetiracetam and introducing again corticosteroids. DRESS has been reported more frequently with other antiepileptics, rarely with levetiracetam. Clinicians should add this drug to the list of potential causes of AKI.
文摘Objective:To study the influence of adjuvant levetiracetam therapy on serum nerve cytokines and apoptosis molecules in patients with refractory partial epileptic seizure.Methods: A total of 92 patients with refractory partial epileptic seizure treated in our hospital between July 2012 and January 2016 were divided into control group (n=46) and observation group (n=46) according to random number table. Patients in the control group were treated with routine treatment, those in observation group were treated with routine treatment plus adjuvant levetiracetam therapy, and the treatment lasted for 20 weeks. Serum contents of nerve cytokines and apoptosis molecules were compared between two groups before and after treatment.Results:Before treatment, differences in serum levels of nerve injury indexes, nerve protection indexes, monoamine neurotransmitters and apoptosis molecules were not statistically significant between two groups of patients. After treatment, serum contents of nerve injury indexes S-100β, GFAP, NSE and MBP in both groups were significantly lower than those before treatment, contents of nerve protection indexes BDNF and IGF-1 were significantly higher than those before treatment, contents of monoamine neurotransmitters DA, 5-HT and NE were significantly higher than those before treatment, contents of apoptosis molecules Bcl-2, Fas and FasL were significantly lower than those before treatment, and the changes in contents of above indexes in observation group were larger than those in control group.Conclusion:The adjunctive therapy of levetiracetam can reduce the nerve injury in patients with refractory partial epileptic seizure and exert active cerebral protective effect.
文摘Epilepsy is a common neurological disorder in neurology clinic. Levetiracetam is considered as one of common antiepileptic drugs used to manage epilepsy with good efficacy and tolerability profile. It is renally excreted and not depending on the cytochrome p450. It has adverse effects reported as somnolence, headaches, dizziness, depression and anxiety. Also, it was reported that levetiracetam can cause Acute kidney injury (AKI), renal profile disturbance, that may be related to its way of excretion and possible nephrotoxicity especially with high loading dose. We are reporting a young female patient with epilepsy presented to hospital with status epileptcus and started on loading dose of levetiracetam 3 grams and then maintenance dose of 1 gram twice daily seizure were controlled but she developed acute kidney injury that improved after discontinue leveriracetam and medical management without renal dialysis and discharged home in stable condition. Physician and health care providers should be aware of such rare adverse reaction and available management options for better patient care and outcome.
文摘Objective:To explore the effects of sodium valproate combined with levetiracetam in the treatment of children epilepsy,and its influences on serum S-100βand high mobility group box-1(HMGB-1)in children with epilepsy.Methods:A total of 160 children who were diagnosed as epilepsy in Baogang Hospital of Inner Mongolia from July 2016 to October 2018 were selected as research objects.They were randomly divided into the study group(n=80)and the control group(n=80)by the random number table method,i.e.,they were treated with sodium valproate combined with levetiracetam and sodium valproate alone,respectively.After 16 weeks of treatment,the effective rates of epileptic seizure treatment and the improvement of epileptiform discharge were evaluated,and chi-square test was used for statistical comparison.The related indicators,including serum tumor necrosis factor-(TNF-α),hypersensitive C-reactive protein(hs-CRP),homocysteine(Hcy),haematocrit(HCT),erythrocyte sedimentation rate(ESR),serum S-100βand HMGB-1,were measured before and after treatment.Paired t-test was used for the comparison in the above indicators within a group before and after treatment;group t-test was used for the comparison between two groups.Chi-square test was used for the comparison in the rate of adverse reactions during treatment between two groups.The study was approved by Ethics Committee of Baogang Hospital(Approval No.:BG201606073),and all children’s guardians were required to sign informed consent forms for clinical study.There were no statistically significant differences between two groups in general clinical data(p>0.05),such as sex constituent ratio,age,the course of disease,the frequency of epileptic seizure per year before treatment,the incidence of epileptiform discharge before treatment and the constituent ratio of types of epileptic seizure,etc.Results:1)After treatment,the effective rates of epileptic seizure treatment and the improvement of epileptiform discharge in the study group were 92.5%(74/80)and 85.0%(68/80)respectively,which were both significantly higher than those in the control group[68.8%(55/80)and 58.8%(47/80)],and the differences were statistically significant(Х^(2)=14.444,13.635;p<0.001).2)In the study group,the levels of serum TNF-α,hs-CRP and Hcy,as well as HCT and ESR after treatment were(53.1±14.0)pg/ml,(5.0±2.5)mg/L,(12.5±3.1)μmol/L,(38.1±5.1)%and(3.0±0.5)mm/h respectively,which were all significantly lower than those[(107.9±17.8)pg/ml,(10.1±2.5)mg/L,(42.2±5.8)μmol/L,(45.3±4.5)%and(5.2±0.6)mm/h]before treatment,and all the differences were statistically significant(t=21.644,12.902,40.393,9.468,25.194;p<0.001).In the control group,the levels of serum TNF-α,hs-CRP and Hcy,as well as HCT and ESR after treatment were(60.6±17.8)pg/ml,(8.2±2.2)mg/L,(15.2±3.1)μmol/L,(40.2±3.4)%and(4.5±0.6)mm/h respectively,which were all significantly lower than those[(112.4±14.3)pg/ml,(9.3±3.8)mg/L,(41.1±2.8)μmol/L,(44.6±5.5)%and(5.4±0.8)mm/h]before treatment,and all the differences were statistically significant(t=20.292,2.241,55.456,3.320,8.050;p<0.05).After treatment,the above indicators in the study group were all significantly lower than those in the control group,and all the differences were statistically significant(t=2.962,8.595,5.508,3.064,17.178;p<0.05).3)In the study group,the levels of serum S-100βand HMGB-1 after treatment were(0.65±0.38)μg/L and(5.3±2.4)μg/L respectively,which were significantly lower than those[(0.91±0.32)μg/L and(8.1±2.0)μg/L]before treatment,and the differences were statistically significant(t=4.681,8.020;p<0.001).In the control group,the levels of serum S-100βand HMGB-1 after treatment were(0.78±0.27)μg/L and(6.4±2.2)μg/L respectively,which were significantly lower than those[(0.88±0.25)μg/L and(7.9±1.7)μg/L]before treatment,and the differences were statistically significant(t=2.431,p=.016;t=4.826,p<0.001).After treatment,the levels of serum S-100βand HMGB-1 in the study group were significantly lower than those in the control group,and the differences were statistically significant(t=2.495,p=.014;t=2.840,p=.005).4)There was no significant difference between two groups in the rate of adverse reactions,such as nausea,vomiting,poor appetite,dizziness,drowsiness,hepatic and renal injury during treatment(p>0.05).Conclusions:The efficacy of sodium valproate combined with levetiracetam is obviously better than that of sodium valproate alone in the treatment of children epilepsy.The children patients’serum S-100βand HMGB-1 are more significantly reduced,resulting in a lower rate of adverse reactions,which has a certain clinical value.
基金supported by funding from the High-level New R&D Institute(2019B090904008)the High-level Innovative Research Institute(2021B0909050003)of the Department of Science and Technology of Guangdong Province+4 种基金National Science and Technology Innovation 2030 Major Program(2021ZD0200900)Shanghai Municipal Science and Technology Major Project(2018SHZDZX05)Zhongshan Municipal Bureau of Science and Technology(CXTD2022013)the National Science Fund for Distinguished Young Scholars(81825021)the funding from Zhongshan Municipal Bureau of Science and Technology(210724194041939).
文摘Epilepsy is a common neurological disorder that is primarily treated with antiseizure medications(ASMs).Although dozens of ASMs are available in the clinic,approximately 30%of epileptic patients have medically refractory seizures;other limitations in most traditional ASMs include poor tolerability and drug-drug interactions.Therefore,there is an urgent need to develop alternative ASMs.Levetiracetam(LEV)is a first-line ASM that is well tolerated,has promising efficacy,and has little drug-drug interaction.Although it is widely accepted that LEV acts through a unique therapeutic target synaptic vesicle protein(SV)2A,the molecular basis of its action remains unknown.Even so,the next-generation SV2A ligands against epilepsy based on the structure of LEV have achieved clinical success.This review highlights the research and development(R&D)process of LEV and its analogs,brivaracetam and padsevonil,to provide ideas and experience for the R&D of novel ASMs.
基金funded by the Scientific Research Fund of China Association Against Epilepsy(No 2012002).
文摘Background To compare the preventive effects of levetiracetam and valproate on late-onset post-traumatic seizures in patients with traumatic brain injury(TBI).Methods A total of 95 patients with TBI were recruited from 2017 to 2020.They were randomized into three groups:levetiracetam(LEV)group(n=30)receiving LEV treatment(500 mg,bid,po);valproate group(n=32)receiving sodium valproate(500 mg/d,once daily,po);and control group(n=33)receiving no anti-seizure medication.LEV and valproate were given to corresponding groups within seven days after TBI,and the administration lasted for one month.The incidence of epilepsy and adverse events were evaluated at 7 days and 12 months post-TBI.Results The cumulative incidences of late post-traumatic seizures at the 12-month follow-up in the LEV,valproate,and control groups were 3.33%,12.50%and 15.63%,respectively.The cumulative incidence of late post-traumatic seizures in the LEV group was significantly lower than those in the valproate and control groups(P<0.05).The cumulative incidence of late post-traumatic seizure in the valproate group was not significantly different from that in the control group(P>0.05).Conclusions LEV can reduce the cumulative incidence of late post-traumatic seizures,whereas valproate can not.
