ArticleTherapeutic advances in neurological disorders2014
Prophylactic antiepileptic treatment reduces seizure frequency in natalizumab-associated progressive multifocal leukoencephalopathy.
Article in Therapeutic advances in neurological disorders, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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5 citing papers in PubMed, 9 citations in OpenAlex.
- Progressive multifocal leukoencephalopathy during fumarate monotherapy of psoriasis.Neurology(R) neuroimmunology & neuroinflammation · 2015Article
- Rituximab postprogressive multifocal leukoencephalopathy: a Feasible therapeutic option in selected cases.Therapeutic advances in neurological disorders · 2014Article
- Management of disease-modifying treatments in neurological autoimmune diseases of the central nervous system.Clinical and experimental immunology · 2014Review
- Efficacy and side effects of natalizumab therapy in patients with multiple sclerosis.Journal of central nervous system disease · 2014Review
- Pathologic Findings of Chronic PML-IRIS in a Patient with Prolonged PML Survival Following Natalizumab Treatment.Journal of investigative medicine high impact case reportsArticle
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Authors and funding
8 authors at 2 institutions in 1 country.
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Abstract
objectiveLittle is known about seizures in natalizumab-associated progressive multifocal leukoencephalopathy (NAT-PML).
methodsA review of clinical records of 15 NAT-PML patients with multiple sclerosis (MS) treated at a German university hospital.
resultsSome 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).
conclusionsAlthough 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.
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