The honeymoon effect in adult patients with refractory partial-onset epilepsy under levetiracetam add-on treatment/Refrakter parsiyel baslangicli epilepsili yetiskin hastalarda levetirasetam ekleme tedavisinin balayi etkisi

• Published in: Epilepsi (Istanbul, Turkey) Vol. 19; no. 1; p. 15
• Main Authors: Kutlu, Gulnihal, Gomceli, Yasemin B, Erdal, Abidin, Inan, Levent E
• Format: Journal Article
• Language: Turkish
• Published: KARE Publishing 01.01.2013
• ISSN: 1300-7157
• DOI: 10.5505/epilepsi.2013.48568

Objectives: Resistance to antiepileptic drugs has occurres in some patients. The aim of this study was to evaluate the patients with refractory partial epilepsy who initially responded to levetiracetam (LEV) add-on therapy and who had the seizure frequency return to their baseline after a honeymoon period. Methods: Seven patients with refractory epilepsy, who had transient seizure control with LEV add-on therapy, were included in this study. Age, sex, detailed medical history, epilepsy duration, seizure frequency, concomitant AEDs, time to seizure occurrence after the initiation of LEV, side effects of LEV, cranial magnetic resonance imaging (MRI) and electroencephalography (EEG) data were collected for each patient. Results: Mean age was 26.14[+ or -]5.14 years. Three patients were male and the other four were female. Mean seizure frequency before LEV treatment was 8.71[+ or -]5.25 /month. The seizure-free days with levetiracetam add-on therapy was 51-82 days. After the honeymoon effect, seizure frequency returned to the baseline level and did not changed despite an increase in dosage. Cranial MRI was normal in two patients, while interictal EEG was normal in two patients. Conclusion: The resistance to LEV add-on treatment in patients with refractory partial onset seizures may develop, but the honeymoon effect of LEV was longer in our patients when compared to the drug's literature. Key words: Levetiracetam; partial seizures; epilepsy; refractory seizures; drug resistance. Amac: Antiepileptik ilac tedavisine direnc bazi hastalarda gorulebilmektedir. Bu calismanin amaci baslangicta levetirasetam (LEV) ekleme tedavisine yanit veren ve balayi periyodu sonrasi nobet frekansi baslangic duzeyine gelen hastalari degerlendirmektedir. Gerec ve Yontem: Gecici olarak levetirasetam ekleme tedavisiyle nobet kontrolu saglanan refrakter epilepsili yedi hasta calismaya alindi. Her bir hasta icin yas, cinsiyet, ayrintili tibbi ozgecmis, epilepsi suresi, nobet frekansi, kullanilan antiepileptik ilaclar, LEV baslandiktan sonra nobet gorulunceye kadar gecen sure, LEV yan etkileri, kraniyal manyetik rezonans goruntuleme (MRG) ve elektroensefalografi (EEG) verileri gozden gecirildi. Bulgular: Ortalama yas 26.14[+ or -]5.14 yil idi. Uc hasta erkek ve digerleri kadindi. LEV tedavisi oncesi ortalama nobet sayisi 8.71[+ or -]5.25/aydi. Levetirasetam ekleme tedavisi sonrasi nobetsiz gun sayisi 51-82 gundur. Balayi donemi sonrasi nobet frekansi onceki haline dondu. Bu frekans doz artimina ragmen degismedi. Interiktal EEG iki hastada normalken kraniyal MRG iki hastada normal bulundu. Sonuc: Refrakter parsiyel baslangicli nobetlerde LEV ekleme tedavisine direnc gelisebilir, fakat bizim hastalarimizda LEV balayi etkisi ilac literaturuyle karsilastirildiginda daha uzundur. Anahtar sozcukler: Levetirasetam; parsiyel nobetler; epilepsi; sik nobetler; ilac direnci.