Authors :
Presenting Author: Iris E. Martínez-Juárez, MD, MSc – National Institute of Neurology and Neurosurgery. Mexico City, Mexico
Irving Fuentes-Calvo, MD – National Institute of Neurology and Neurosurgery. Mexico City, Mexico
Jimena Gonzalez-Salido, MD – National Institute of Neurology and Neurosurgery. Mexico City, Mexico
Jimena Colado, MD – Epilepsy Clinic, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
Fernando Vasquez-Lopez, MD – National Institute of Neurology and Neurosurgery. Mexico City, Mexico
Betsy C. Vázquez-Cruz, MD – National Institute of Neurology and Neurosurgery. Mexico City, Mexico
Eithel A. Valenzuela-Mendivil, MD – National Institute of Neurology and Neurosurgery. Mexico City, Mexico
Mijaíl Adán Rivas-Cruz, MD – National Institute of Neurology and Neurosurgery. Mexico City, Mexico
Mario A. Sebastián-Díaz, MD,PHD – South Central High Specialty Hospital PEMEX
Adriana Ochoa, MS – Instituto Nacional de Neurología y Neurocirugía
Aurelio Jara-Prado, phD – Instituto Nacional de Neurología y Neurocirugía
Vicente Villanueva, MD – Refractory Epilepsy Unit, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
Rationale:
In the coming years, newer drugs may hold promise to treat refractory genetic generalized epilepsy (GGE), including brivaracetam (BRV); despite the current use of BRV for focal-onset seizures clinical studies have shown efficacy and adequate safety in patients with GGE (3). Concern refractory GGE is reported among the 20% of GGE cases. Additionally, recent studies have identified resistance to valproate as a major predictor of drug-resistant epilepsy and unfavorable social outcomes in patients with GGE (4).
Methods:
It modulates synaptic vesicle glycoprotein 2A with high affinity, showing a binding potential 10 to 30 times greater than that of LEV (5). A case series of five patients presenting with a diagnosis of genetic generalized epilepsy refractory to previous treatments at the Hospital Ángeles Acoxpa in Mexico City were described.Results:
Five patients diagnosed with genetic generalized epilepsy that had not responded to other ASD were included. Four female and one male, 2/5 had JME, 1 of GTC only, 1 of Adolescent Absence epilepsy, and one of Childhood absence epilepsy evolving to JME. 4/5 patients had absence seizures. The mean BRV dosage was 205 mg/ day. The time taking BRV was from 6 months to 4 years. Four of the patients had polytherapy, three of five patients had valproate (VPA), and one had lamotrigine (LTG) and clobazam (CLB). Regarding seizure outcome, all patients had freedom from GTC seizures during the time taking BRV.
Conclusions:
In this case series, favorable outcomes have been observed in patients with GGE using BRV as an alternative to other treatment lines with good control of GTCS. This highlights a knowledge gap, as very few reported series exist worldwide of BRV use in GGE. It is also important to stress the good outcome achieved in syndromes with absence seizures that can be hard to treat (6).Funding:
The authors reported that there is no funding associated with the abstract.