Antiepileptics
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Antiepileptics Neurological disorders and lack of efficacy: 4 case reports
In a case report, 4 men aged 24–56 years were described, who developed neuropsychiatric symptoms, dizziness, drowsiness or exhibited lack of efficacy during treatment with levetiracetam, lacosamide, oxcarbazepine, valproic acid, topiramate, ethosuximide, phenytoin, pregabalin or tiagabine [routes, dosages and durations of treatments to reactions onsets not stated; not all outcomes stated]. A 24-year-old man exhibited lack of efficacy during treatment with valproic acid, levetiracetam and ethosuximide for partial epilepsy: The man had lifelong partial epilepsy and daily seizures when he was initially evaluated, and he received an antiepileptic drug (AED) regimen comprised of valproic acid, levetiracetam and ethosuximide without effect (lack of efficacy). Subsequently, his levetiracetam and ethosuximide therapy was discontinued and he was started on combination therapy of valproic acid and lamotrigine with marked improvement. A 56-year-old man developed neuropsychiatric symptoms during treatment with levetiracetam for seizures: The man, who had continuous seizure and resected arteriovenous malformation, was initiated on levetiracetam during hospitalisation. However, he developed profound neuropsychiatric symptoms. Therefore, he was started on lamotrigine. Eventually, his neuropsychiatric symptoms resolved at a low dose of lamotrigine. Subsequently, his levetiracetam therapy was tapered off after reaching a therapeutic dose of lamotrigine. One week later, he developed a recurrent seizure. Therefore, upon his request, levetiracetam treatment was re-started along with the continuation of lamotrigine. Eventually, his seizures resolved without recurrence of neuropsychiatric symptoms. A 29-year-old man developed dizziness during treatment with lacosamide and oxcarbazepine, and exhibited a lack of efficacy during treatment with phenytoin, pregabalin, oxcarbazepine and tiagabine for refractory epilepsy: The man had refractory epilepsy with daily seizures while receiving phenytoin, pregabalin, oxcarbazepine and tiagabine therapy (lack of efficacy). Therefore, his pregabalin treatment was tapered off and he was started on lacosamide. Eventually, a marked improvement in his seizures was noted. However, he developed severe dizziness. Later, his lacosamide therapy was moved from 8am and 10pm to strictly 12 hours apart, and oxcarbazepine and lacosamide were separated by 2 hours. Eventually, his dizziness resolved. A 50-year-old man developed drowsiness and dizziness during treatment with levetiracetam, valproic acid and topiramate for complex partial seizure: The man had a complex partial seizure with secondary generalisation. Thereafter, he underwent surgery. Despite surgery, he experienced frequent sensory seizures. Therefore, he was started on high dose levetiracetam, valproic acid and topiramate therapy. However, he developed increasing drowsiness and dizziness. Subsequently, his levetiracetam dose was tapered and improvement in his condition was
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