title: A pilot trial of levetiracetam in eyelid myoclonia with absences (Jeavons syndrome).
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.
  
  
  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 > or =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.
  
  
  CONCLUSIONS
  Levetiracetam is effective and well tolerated in EMA. Placebo-controlled studies should confirm these findings.
authors.affiliation: Epilepsy Center, Department of Neurological Sciences, Federico II University, Napoli, Italy. pstriano@email.it
authors.forename: Pasquale
authors.initials: P
authors.lastname: Striano
authors.forename: Vito
authors.initials: V
authors.lastname: Sofia
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Capovilla
authors.forename: Guido
authors.initials: G
authors.lastname: Rubboli
authors.forename: Carlo
authors.initials: C
authors.lastname: Di Bonaventura
authors.forename: Antonietta
authors.initials: A
authors.lastname: Coppola
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Vitale
authors.forename: Luis
authors.initials: L
authors.lastname: Fontanillas
authors.forename: Anna Teresa
authors.initials: AT
authors.lastname: Giallonardo
authors.forename: Roberto
authors.initials: R
authors.lastname: Biondi
authors.forename: Antonino
authors.initials: A
authors.lastname: Romeo
authors.forename: Maurizio
authors.initials: M
authors.lastname: Viri
authors.forename: Federico
authors.initials: F
authors.lastname: Zara
authors.forename: Salvatore
authors.initials: S
authors.lastname: Striano
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D002648:Child; D015897:Comorbidity; D004359:Drug Therapy, Combination; D004831:Epilepsies, Myoclonic / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D004832:Epilepsy, Absence / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D020195:Epilepsy, Reflex / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D005143:Eyelids / Q000187:drug effects / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000077287:Levetiracetam; D008297:Male; D009207:Myoclonus / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D010865:Pilot Projects; D010889:Piracetam / Q000031:analogs & derivatives* / Q000627:therapeutic use; D013577:Syndrome; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants; D000077287:Levetiracetam; D010889:Piracetam