[Brivaracetam - A Good Alternative in the Acute Treatment of Trigeminal Neuralgia]. / Brivaracetam ­ eine gute Alternative in der akuten Behandlung der Trigeminusneuralgie.

Brivaracetam - A Good Alternative in the Acute Treatment of Trigeminal Neuralgia Abstract. In trigeminal neuralgia there is brief neuropathic pain in the supply area of the trigeminal nerve. A distinction is made between classic, symptomatic, and idiopathic trigeminal neuralgia. Only a few drugs are available for acute treatment. In the presented case series, we report on five patients with trigeminal neuralgia of various origins who responded well to treatment with brivaracetam. Brivaracetam binds to the synaptic vesicle protein 2A, which is also found on nerves and nerve roots. SV2 regulates the exocytotic release of neurotransmitters, which may explain the effect of brivaracetam on neuropathic pain. The use of brivaracetam can be helpful in the short-term therapy of paroxysmal pain with trigeminal neuralgia. Further studies are required to demonstrate this effect and to rule out a placebo effect.

[Brivaracetam-A good alternative for the treatment of muscle cramps]. / Brivaracetam ­ eine gute Alternative zur Behandlung von Muskelkrämpfen.

BACKGROUND: Muscle cramps are suddenly occurring involuntary, mostly painful contractions of a single muscle, rarely of a muscle group. They can be idiopathic or occur in various neuromuscular diseases and can sometimes substantially impair the quality of life due to the frequency and strength. Only a few drugs are available for the effective treatment of cramps. RESULTS: In this case series we report on five patients with cramps of different origin who responded well to treatment with brivaracetam. DISCUSSION: Brivaracetam is actually used for the treatment of epileptic seizures. It binds to the synaptic vesicle protein 2A (SV2A), which also occurs in nerves and nerve roots. The SV2A regulates the exocytotic release of neurotransmitters, which could explain the effect of brivaracetam on muscle cramps. CONCLUSION: Further studies are needed to demonstrate the effect of brivaracetam on muscle cramps.

Negative pressure wound treatment with computer-controlled irrigation/instillation decreases bacterial load in contaminated wounds and facilitates wound closure.

Microbial wound contamination is known to be a hindrance to wound healing. Negative pressure wound therapy (NPWT) with or without irrigation is known to optimise conditions in problem wounds. The aim of this study was to investigate the influence of computer-controlled wound irrigation with NPWT on the bacterial load in contaminated wounds. A total of 267 patients were treated with NPWT with automated instillation because of problematic wounds using an antiseptic instillation solution. In 111 patients, a minimum of 4 operative procedures were necessary, and swabs were taken at least at the first and at the fourth operation in a standardised procedure. The number of different bacteria and the amount of bacteria were analysed during the course. In a subgroup of 51 patients, swabs were taken at all 4 operative procedures and analysed separately. In an overall analysis, the number of different bacteria and the amount of bacteria significantly decreased independent of wound localisation and diagnosis. NPWT with automated instillation demonstrates a positive influence in the reduction of bacterial load in problem wounds. Thus, it may help to optimise wound conditions before definite wound closure.