Progressive Myoclonic Epilepsies.
The treatment of progressive myoclonus epilepsy (PME) remains a major therapeutic challenge in neurology. Generalized convulsive seizures are often well controlled through classic antiepileptic drugs (AEDs) like valproate and clonazepam, whereas myoclonus, the main symptom that is affecting patients most in their daily life, is usually refractory to standard AEDs. Alternative therapy concepts have been and still are investigated. Among the new drugs, zonisamide and piracetam have shown the most promising results as add-on treatments. Other therapeutic approaches, like the use of antioxidants, 5-hydroxytryptophan (5-HTP), and baclofen should also be taken into consideration for the treatment of intractable cases of PME. Nonpharmacologic treatment options such as diet and physical therapy should always be considered, because they may save costs and side effects. In some instances, the occasional use of alcohol has shown beneficial effects.
Uthman
Basim M.
BM
University of Florida College of Medicine, Department of Neurology and Neurosciences, Malcom Randall Veterans Affairs Medical Center, Neurology Service (127), 1601 SW Archer Road, Gainesville, FL 32608, USA. Basim.Uthman@med.va.gov
Reichl
Andreas
A