Prophylactic antiepileptic treatment reduces seizure frequency in natalizumab-associated progressive multifocal leukoencephalopathy
Objective: Little is known about seizures in natalizumab-associated progressive multifocal leukoencephalopathy (NAT-PML). Methods: A review of clinical records of 15 NAT-PML patients with multiple sclerosis (MS) treated at a German university hospital. Results: Some 53% (8/15) of our patients develo...
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Series: | Therapeutic Advances in Neurological Disorders |
Online Access: | https://doi.org/10.1177/1756285613503515 |
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doaj-ea8fe2c382494321aba3f199f6db8aa62020-11-25T03:40:52ZengSAGE PublishingTherapeutic Advances in Neurological Disorders1756-28561756-28642014-01-01710.1177/1756285613503515Prophylactic antiepileptic treatment reduces seizure frequency in natalizumab-associated progressive multifocal leukoencephalopathyRobert HoepnerStefanie DahlhausSusanne KollarBarbara ZurawskiAndrew ChanIngo KleiterRalf GoldKerstin HellwigObjective: Little is known about seizures in natalizumab-associated progressive multifocal leukoencephalopathy (NAT-PML). Methods: A review of clinical records of 15 NAT-PML patients with multiple sclerosis (MS) treated at a German university hospital. Results: Some 53% (8/15) of our patients developed seizures with often multiple semiologies (seven grand mal, three simple partial motor and two psychomotor seizures). Series of seizures or status epilepticus occurred in seven of these eight. Seizure onset was on average 61 days after onset of NAT-PML and was associated with immune reconstitution inflammatory syndrome (IRIS) in five of eight patients. After having observed severe seizures during NAT-PML in seven of our first nine patients, we started preventive antiepileptic treatment (PAT) with levetiracetam (1000–1750 mg/day). Patient subgroups analyzed for seizures and PAT did not differ in baseline characteristics. Only one of six patients, who received PAT, had a seizure compared with seven of nine patients without PAT (2-tailed Fisher’s exact test, p = 0.04). Conclusions: Although the small sample size and retrospective nature of the study are limitations, we propose to treat NAT-PML patients with PAT early after diagnosis, as seizures seem to be common and severe in NAT-PML.https://doi.org/10.1177/1756285613503515 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Robert Hoepner Stefanie Dahlhaus Susanne Kollar Barbara Zurawski Andrew Chan Ingo Kleiter Ralf Gold Kerstin Hellwig |
spellingShingle |
Robert Hoepner Stefanie Dahlhaus Susanne Kollar Barbara Zurawski Andrew Chan Ingo Kleiter Ralf Gold Kerstin Hellwig Prophylactic antiepileptic treatment reduces seizure frequency in natalizumab-associated progressive multifocal leukoencephalopathy Therapeutic Advances in Neurological Disorders |
author_facet |
Robert Hoepner Stefanie Dahlhaus Susanne Kollar Barbara Zurawski Andrew Chan Ingo Kleiter Ralf Gold Kerstin Hellwig |
author_sort |
Robert Hoepner |
title |
Prophylactic antiepileptic treatment reduces seizure frequency in natalizumab-associated progressive multifocal leukoencephalopathy |
title_short |
Prophylactic antiepileptic treatment reduces seizure frequency in natalizumab-associated progressive multifocal leukoencephalopathy |
title_full |
Prophylactic antiepileptic treatment reduces seizure frequency in natalizumab-associated progressive multifocal leukoencephalopathy |
title_fullStr |
Prophylactic antiepileptic treatment reduces seizure frequency in natalizumab-associated progressive multifocal leukoencephalopathy |
title_full_unstemmed |
Prophylactic antiepileptic treatment reduces seizure frequency in natalizumab-associated progressive multifocal leukoencephalopathy |
title_sort |
prophylactic antiepileptic treatment reduces seizure frequency in natalizumab-associated progressive multifocal leukoencephalopathy |
publisher |
SAGE Publishing |
series |
Therapeutic Advances in Neurological Disorders |
issn |
1756-2856 1756-2864 |
publishDate |
2014-01-01 |
description |
Objective: Little is known about seizures in natalizumab-associated progressive multifocal leukoencephalopathy (NAT-PML). Methods: A review of clinical records of 15 NAT-PML patients with multiple sclerosis (MS) treated at a German university hospital. Results: Some 53% (8/15) of our patients developed seizures with often multiple semiologies (seven grand mal, three simple partial motor and two psychomotor seizures). Series of seizures or status epilepticus occurred in seven of these eight. Seizure onset was on average 61 days after onset of NAT-PML and was associated with immune reconstitution inflammatory syndrome (IRIS) in five of eight patients. After having observed severe seizures during NAT-PML in seven of our first nine patients, we started preventive antiepileptic treatment (PAT) with levetiracetam (1000–1750 mg/day). Patient subgroups analyzed for seizures and PAT did not differ in baseline characteristics. Only one of six patients, who received PAT, had a seizure compared with seven of nine patients without PAT (2-tailed Fisher’s exact test, p = 0.04). Conclusions: Although the small sample size and retrospective nature of the study are limitations, we propose to treat NAT-PML patients with PAT early after diagnosis, as seizures seem to be common and severe in NAT-PML. |
url |
https://doi.org/10.1177/1756285613503515 |
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