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Erschienen in: Zeitschrift für Epileptologie 4/2017

14.06.2017 | Intelligenzminderung | Leitthema

Antiepileptika – Besonderheiten bei Menschen mit geistiger Behinderung

verfasst von: Dr. med. Frank Kerling, Christian Brandt, Hartmut Baier

Erschienen in: Clinical Epileptology | Ausgabe 4/2017

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Zusammenfassung

Die Häufigkeit von Epilepsien ist bei Patienten mit geistiger Behinderung im Vergleich zu anderen Patienten deutlich erhöht. Nicht selten handelt es sich dabei um therapieschwierige Epilepsien. Die ätiologische Klärung des Epilepsiesyndroms hat zum Teil therapeutische Konsequenzen z. B. durch Einsatz oder Vermeiden bestimmter Antiepileptika und muss daher am Anfang einer gezielten Behandlung stehen. Die zahlreichen medikamentösen Optionen werden in diesem Artikel charakterisiert. Dabei wird v. a. auf die neueren Antiepileptika (Zulassung seit 1990) eingegangen. Die Datenlage zu den einzelnen Substanzen ist für die Gruppe der Menschen mit geistiger Behinderung nach wie vor überschaubar. Trotzdem ergeben sich aus diesen Arbeiten wichtige Hinweise für die Behandlung. Zusätzlich wird auf die sog. Orphan drugs mit eingeschränkter Indikation eingegangen.
Literatur
1.
Zurück zum Zitat Andrade-Machado R, Benjumea-Cuartas V, Jaramillo-Jimenez E (2012) Lacosamide in Lennox-Gastaut syndrome: case report. Clin Neuropharmacol 35(3):148–149CrossRefPubMed Andrade-Machado R, Benjumea-Cuartas V, Jaramillo-Jimenez E (2012) Lacosamide in Lennox-Gastaut syndrome: case report. Clin Neuropharmacol 35(3):148–149CrossRefPubMed
2.
Zurück zum Zitat Andres E, Kerling F, Winterholler M (2017) Behavioural changes in patients with intellectual disability treated with perampanel. Acta Neurol Scand. doi:10.1111/ane.12781 PubMed Andres E, Kerling F, Winterholler M (2017) Behavioural changes in patients with intellectual disability treated with perampanel. Acta Neurol Scand. doi:10.​1111/​ane.​12781 PubMed
3.
4.
Zurück zum Zitat Beran RG, Gibson RJ (1998) Aggressive behaviour in intellectually challenged patients with epilepsy treated with lamotrigine. Epilepsia 39:280–282CrossRefPubMed Beran RG, Gibson RJ (1998) Aggressive behaviour in intellectually challenged patients with epilepsy treated with lamotrigine. Epilepsia 39:280–282CrossRefPubMed
5.
Zurück zum Zitat Brandt C, Lahr D, May TW (2015) Cognitive adverse events of topiramate in patients with epilepsy and intellectual disability. Epilepsy Behav 45:261–264CrossRefPubMed Brandt C, Lahr D, May TW (2015) Cognitive adverse events of topiramate in patients with epilepsy and intellectual disability. Epilepsy Behav 45:261–264CrossRefPubMed
6.
Zurück zum Zitat Brandt C, May TW, Bien CG (2016) Brivaracetam as adjunctive therapy for the treatment of partial-onset seizures in patients with epilepsy: the current evidence base. Ther Adv Neurol Disord 9:474–482CrossRefPubMedPubMedCentral Brandt C, May TW, Bien CG (2016) Brivaracetam as adjunctive therapy for the treatment of partial-onset seizures in patients with epilepsy: the current evidence base. Ther Adv Neurol Disord 9:474–482CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Chiron C, Marchand MC, Tran A, Rey E, d’Athis P, Vincent J, Dulac O, Pons G, the STICLO study group (2000) Stiripentol in severe myoclonic epilepsy in infancy: a randomised placebo-controlled syndrome-dedicated trial. Lancet 356(9242):1638–1642CrossRefPubMed Chiron C, Marchand MC, Tran A, Rey E, d’Athis P, Vincent J, Dulac O, Pons G, the STICLO study group (2000) Stiripentol in severe myoclonic epilepsy in infancy: a randomised placebo-controlled syndrome-dedicated trial. Lancet 356(9242):1638–1642CrossRefPubMed
8.
Zurück zum Zitat Coppola G, Verrotti A, Resicato G, Ferrarelli S, Auricchio G, Operto FF, Pascotto A (2007) Topiramate in children and adolescents with epilepsy and mental retardation. A prospective study on behavior and cognitive effects. Epilepsy Behav 12:253–256CrossRefPubMed Coppola G, Verrotti A, Resicato G, Ferrarelli S, Auricchio G, Operto FF, Pascotto A (2007) Topiramate in children and adolescents with epilepsy and mental retardation. A prospective study on behavior and cognitive effects. Epilepsy Behav 12:253–256CrossRefPubMed
9.
Zurück zum Zitat Crawford P, Brown S, Kerr M, Parke Davis Clinical Trials Group (1998) A randomized open-label study of gabapentin and lamotrigine in adults with learning disability and resistant epilepsy. Seizure 10:107–1156CrossRef Crawford P, Brown S, Kerr M, Parke Davis Clinical Trials Group (1998) A randomized open-label study of gabapentin and lamotrigine in adults with learning disability and resistant epilepsy. Seizure 10:107–1156CrossRef
10.
Zurück zum Zitat Curatolo P (2015) Mechanistic target of rapamycin (mTOR) in tuberous sclerosis complex-associated epilepsy. Pediatr Neurol 52(3):281–289CrossRefPubMed Curatolo P (2015) Mechanistic target of rapamycin (mTOR) in tuberous sclerosis complex-associated epilepsy. Pediatr Neurol 52(3):281–289CrossRefPubMed
11.
Zurück zum Zitat Dinkelacker V, Dietl T, Widmann G, Lengler U, Elger CE (2003) Aggressive behavior of epilepsy patients in the course of levetiracetam add-on therapy: report of 33 mild to severe cases. Epilepsy Behav 4:537–547CrossRefPubMed Dinkelacker V, Dietl T, Widmann G, Lengler U, Elger CE (2003) Aggressive behavior of epilepsy patients in the course of levetiracetam add-on therapy: report of 33 mild to severe cases. Epilepsy Behav 4:537–547CrossRefPubMed
12.
Zurück zum Zitat Felbamate Study Group in Lennox-Gastaut Syndrome (1993) Efficacy of Felbamate in childhood epileptic encephalopathy (Lennox-Gastaut syndrome). N Engl J Med 328(1):29–33CrossRef Felbamate Study Group in Lennox-Gastaut Syndrome (1993) Efficacy of Felbamate in childhood epileptic encephalopathy (Lennox-Gastaut syndrome). N Engl J Med 328(1):29–33CrossRef
13.
Zurück zum Zitat Forsgren L, Beghi E, Oun A, Sillanpaa M (2005) The epidemiology of epilepsy in Europe – a systematic review. Eur J Neurol 12:245–253CrossRefPubMed Forsgren L, Beghi E, Oun A, Sillanpaa M (2005) The epidemiology of epilepsy in Europe – a systematic review. Eur J Neurol 12:245–253CrossRefPubMed
14.
Zurück zum Zitat French JA, Lawson JA, Yapici Z, Ikeda H, Polster T, Nabbout R (2016) Adjunctive everolimus therapy for treatment-resistant focal-onset seizures associated with tuberous sclerosis (EXIST-3): a phase 3, randomised, double-blind, placebo-controlled study. Lancet 388(10056):2153–2163CrossRefPubMed French JA, Lawson JA, Yapici Z, Ikeda H, Polster T, Nabbout R (2016) Adjunctive everolimus therapy for treatment-resistant focal-onset seizures associated with tuberous sclerosis (EXIST-3): a phase 3, randomised, double-blind, placebo-controlled study. Lancet 388(10056):2153–2163CrossRefPubMed
15.
Zurück zum Zitat Gaily E, Granström ML, Liukonnen E (1998) Oxcarbazepine in the treatment of epilepsy in children and adolescents with intellectual disability and epilepsy. J Intellect Disabil Res 42(Suppl 1):41–45PubMed Gaily E, Granström ML, Liukonnen E (1998) Oxcarbazepine in the treatment of epilepsy in children and adolescents with intellectual disability and epilepsy. J Intellect Disabil Res 42(Suppl 1):41–45PubMed
16.
Zurück zum Zitat Gilliam F, Carter J, Vahle V (2004) Tolerability of antiseizure medications: implications for health outcomes. Neurology 63:S9–S12CrossRefPubMed Gilliam F, Carter J, Vahle V (2004) Tolerability of antiseizure medications: implications for health outcomes. Neurology 63:S9–S12CrossRefPubMed
17.
Zurück zum Zitat Glauser TA, Kluger G, Sachdeo R, Krauss G, Perdomo C, Arroyo A (2008) Rufinamide for generalized seizures associated with Lennox-Gastaut syndrome. Neurology 70:1950–1958CrossRefPubMed Glauser TA, Kluger G, Sachdeo R, Krauss G, Perdomo C, Arroyo A (2008) Rufinamide for generalized seizures associated with Lennox-Gastaut syndrome. Neurology 70:1950–1958CrossRefPubMed
18.
Zurück zum Zitat Huber B, May T, Seidel M (1998) Lamotrigine in multihandicapped therapy-resistant epileptic patients. Clin Drug Investig 16(4):263–277CrossRefPubMed Huber B, May T, Seidel M (1998) Lamotrigine in multihandicapped therapy-resistant epileptic patients. Clin Drug Investig 16(4):263–277CrossRefPubMed
19.
Zurück zum Zitat Huber B, Tomka-Hoffmeister M (2003) Limited efficacy of gabapentin in severe therapy-resistant epilepsies of learning disabled patients. Seizure 12(8):602–603CrossRefPubMed Huber B, Tomka-Hoffmeister M (2003) Limited efficacy of gabapentin in severe therapy-resistant epilepsies of learning disabled patients. Seizure 12(8):602–603CrossRefPubMed
20.
Zurück zum Zitat Huber B, Bömmel W, Hauser I, Horstmann V, Liem S, May T, Meinert T, Robertson E, Schulz L, Seidel M, Tomka-Hoffmeister M, Wagner W (2004) Efficacy and tolerability of levetiracetam in patients with therapy-resistant epilepsy and learning disabilities. Seizure 13(3):168–175CrossRefPubMed Huber B, Bömmel W, Hauser I, Horstmann V, Liem S, May T, Meinert T, Robertson E, Schulz L, Seidel M, Tomka-Hoffmeister M, Wagner W (2004) Efficacy and tolerability of levetiracetam in patients with therapy-resistant epilepsy and learning disabilities. Seizure 13(3):168–175CrossRefPubMed
21.
Zurück zum Zitat Huber B, Hauser I, Horstmann V, Jokeit G, Liem S, Meinert T (2005) Seizure freedom with different therapeutic regimens in intellectually disabled epileptic patients. Seizure 14(6):381–386CrossRefPubMed Huber B, Hauser I, Horstmann V, Jokeit G, Liem S, Meinert T (2005) Seizure freedom with different therapeutic regimens in intellectually disabled epileptic patients. Seizure 14(6):381–386CrossRefPubMed
22.
Zurück zum Zitat Huber B, Bocchicchio M, Feuerbaum E, May T, Meinert T, Robertson E, Schorlemmer H, Wagner W, Wilking E, Seidel M (2008) Epilepsy and tolerability of pregabalin in patients with difficult-to-treat epilepsy and intellectual disability. Epilepsy Behav 13:397–401CrossRefPubMed Huber B, Bocchicchio M, Feuerbaum E, May T, Meinert T, Robertson E, Schorlemmer H, Wagner W, Wilking E, Seidel M (2008) Epilepsy and tolerability of pregabalin in patients with difficult-to-treat epilepsy and intellectual disability. Epilepsy Behav 13:397–401CrossRefPubMed
23.
Zurück zum Zitat Huber B (2014) Increased risk of suicidality on perampanel (Fycompa®)? Epilepsy Behav 31:71–72CrossRefPubMed Huber B (2014) Increased risk of suicidality on perampanel (Fycompa®)? Epilepsy Behav 31:71–72CrossRefPubMed
24.
Zurück zum Zitat Hurtado B, Koepp MJ, Sander JW, Thompson PJ (2006) The impact of levetiracetam on challenging behavior. Epilepsy Behav 8:588–592CrossRefPubMed Hurtado B, Koepp MJ, Sander JW, Thompson PJ (2006) The impact of levetiracetam on challenging behavior. Epilepsy Behav 8:588–592CrossRefPubMed
25.
Zurück zum Zitat Iinuma K, Minami T, Cho K, Kajii N, Tachi N (1998) Long-term effects of zonisamide in the treatment of epilepsy in children with intellectual disability. J Intellect Disabil Res 42(Suppl 1):68–73PubMed Iinuma K, Minami T, Cho K, Kajii N, Tachi N (1998) Long-term effects of zonisamide in the treatment of epilepsy in children with intellectual disability. J Intellect Disabil Res 42(Suppl 1):68–73PubMed
26.
Zurück zum Zitat Kelly K, Stephen LJ, Brodie MJ (2004) Levetiracetam for people with mental retardation and refractory epilepsy. Epilepsy Behav 5:878–883CrossRefPubMed Kelly K, Stephen LJ, Brodie MJ (2004) Levetiracetam for people with mental retardation and refractory epilepsy. Epilepsy Behav 5:878–883CrossRefPubMed
27.
Zurück zum Zitat Kerr MP, Baker GA, Brodie MJ (2005) A randomized, double-blind, placebo-controlled trial of topiramate in adults with epilepsy and intellectual disability: impact on seizures, severity, and quality of life. Epilepsy Behav 7:472–480CrossRefPubMed Kerr MP, Baker GA, Brodie MJ (2005) A randomized, double-blind, placebo-controlled trial of topiramate in adults with epilepsy and intellectual disability: impact on seizures, severity, and quality of life. Epilepsy Behav 7:472–480CrossRefPubMed
28.
Zurück zum Zitat Kerr M, Scheepers M, Arvio M, Beavis J, Brandt C, Brown S (2009) Consensus guidelines into the management of epilepsy in adults with an intellectual disability. J Intellect Disabil Res 53(8):687–694CrossRefPubMed Kerr M, Scheepers M, Arvio M, Beavis J, Brandt C, Brown S (2009) Consensus guidelines into the management of epilepsy in adults with an intellectual disability. J Intellect Disabil Res 53(8):687–694CrossRefPubMed
29.
Zurück zum Zitat Kwan P, Brodie MJ (2000) Early identification of refractory epilepsy. N Engl J Med 342:314–319CrossRefPubMed Kwan P, Brodie MJ (2000) Early identification of refractory epilepsy. N Engl J Med 342:314–319CrossRefPubMed
30.
Zurück zum Zitat Martin P, Schreiner A, Rettig K, Schäuble B (2009) Topiramate in patients with epilepsy and intellectual disability. Epilepsy Behav 14(3):496–502CrossRefPubMed Martin P, Schreiner A, Rettig K, Schäuble B (2009) Topiramate in patients with epilepsy and intellectual disability. Epilepsy Behav 14(3):496–502CrossRefPubMed
31.
Zurück zum Zitat McDermott S, Moran R, Platt T, Wood H, Isaac T, Dasari S (2005) Prevalence of epilepsy in adults with mental retardation and related disabilities in primary care. Am J Ment Retard 110(1):48–56CrossRefPubMed McDermott S, Moran R, Platt T, Wood H, Isaac T, Dasari S (2005) Prevalence of epilepsy in adults with mental retardation and related disabilities in primary care. Am J Ment Retard 110(1):48–56CrossRefPubMed
32.
Zurück zum Zitat McGrother CW, Bhaumik S, Thorp CF, Hauck A, Branford D, Watson JM (2006) Epilepsy in adults with intellectual disabilities: prevalence, associations and service implications. Seizure 15:376–386CrossRefPubMed McGrother CW, Bhaumik S, Thorp CF, Hauck A, Branford D, Watson JM (2006) Epilepsy in adults with intellectual disabilities: prevalence, associations and service implications. Seizure 15:376–386CrossRefPubMed
33.
Zurück zum Zitat Modur PN, Milteer WE (2008) Adjunctive pregabalin therapy in mentally retarded, developmentally delayed patients with epilepsy. Epilepsy Behav 13:554–556CrossRefPubMed Modur PN, Milteer WE (2008) Adjunctive pregabalin therapy in mentally retarded, developmentally delayed patients with epilepsy. Epilepsy Behav 13:554–556CrossRefPubMed
34.
Zurück zum Zitat Sunder TR, McKee JR, Hammer AE, Vuong A (2006) Efficacy and tolerability of adjunctive lamotrigine for refractory epilepsy in institutional or community residents with mental retardation. Curr Med Res Opin 22:693–702CrossRefPubMed Sunder TR, McKee JR, Hammer AE, Vuong A (2006) Efficacy and tolerability of adjunctive lamotrigine for refractory epilepsy in institutional or community residents with mental retardation. Curr Med Res Opin 22:693–702CrossRefPubMed
35.
Zurück zum Zitat Yates SL, Fakhoury T, Liang W, Eckhardt K, Borghs S, D’Souza J (2015) An open-label, prospective, exploratory study of patients with epilepsy switching from levetiracetam to brivaracetam. Epilepsy Behav 52:165–168CrossRefPubMed Yates SL, Fakhoury T, Liang W, Eckhardt K, Borghs S, D’Souza J (2015) An open-label, prospective, exploratory study of patients with epilepsy switching from levetiracetam to brivaracetam. Epilepsy Behav 52:165–168CrossRefPubMed
Metadaten
Titel
Antiepileptika – Besonderheiten bei Menschen mit geistiger Behinderung
verfasst von
Dr. med. Frank Kerling
Christian Brandt
Hartmut Baier
Publikationsdatum
14.06.2017
Verlag
Springer Medizin
Erschienen in
Clinical Epileptology / Ausgabe 4/2017
Print ISSN: 2948-104X
Elektronische ISSN: 2948-1058
DOI
https://doi.org/10.1007/s10309-017-0134-1

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