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Neurology supplements are not peer-reviewed. Information contained in Neurology supplements represent the opinions of the authors and are not endorsed by nor do they reflect the views of the American Academy of Neurology, Editor-in-Chief, or Associate Editors of Neurology.

Pharmacologic management of seizures in organ transplant

From the Department of Neurology, Mayo Clinic, Jacksonville, Florida.

Address correspondence and reprint requests to Dr. David R. Chabolla, Department of Neurology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224; e-mail: dchabolla{at}mayo.edu.

Seizures in a transplant candidate or recipient raise complicated management issues, but there are no results from controlled drug trials to guide their pharmacologic treatment. Most seizures in the transplant population are isolated events that do not require long-term antiseizure therapy. Short-term therapy, however, can reduce seizure recurrence. This review focuses on the pharmacologic management issues associated with acute and short-term therapy of seizures in this population. Phenytoin, fosphenytoin, and phenobarbital are current first-line therapies. The interactions between immunosuppressants and these antiepileptic drugs (AEDs) are of particular importance because the latter may reduce immunosuppressant blood levels. Other, newer agents are not subject to this interaction, and further studies are needed to define their role in the management of seizures in transplant patients.

This supplement has been supported through an unrestricted grant from UCB S.A., manufacturers of levetiracetam (Keppra®).

Disclosure: The authors report no conflicts of interest.

Neurology supplements are not peer-reviewed. Information contained in Neurology supplements represents the opinions of the authors and is not endorsed by nor does it reflect the views of the American Academy of Neurology, Editorial Board, Editor-in-Chief, or Associate Editors of Neurology.