Multifocal myoclonus as a presentation of levetiracetam toxicity
| Autor: | Mohamad Z. Koubeissi, Mei Bou Nasif, Shweta Varade |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Pharmacology
Levetiracetam business.industry Sedation Myoclonic Jerk Multifocal myoclonus Neurosciences. Biological psychiatry. Neuropsychiatry Case Report Status epilepticus medicine.disease Discontinuation Neurology Physiology (medical) Anesthesia medicine Neurology (clinical) medicine.symptom Propofol business Myoclonus Kidney disease medicine.drug RC321-571 |
| Zdroj: | Clinical Neurophysiology Practice Clinical Neurophysiology Practice, Vol 6, Iss, Pp 281-284 (2021) |
| ISSN: | 2467-981X |
| Popis: | Highlights • Levetiracetam (LEV) is a widely used antiseizure medication, but LEV toxicity is not commonly reported. • We report a patient with chronic kidney disease who developed multifocal myoclonus after treatment with LEV. • The findings suggest the possibility of an inverted U-shaped dose–response of the anti-myoclonic effect of LEV. Background Levetiracetam (LEV) is widely used for treatment of focal and myoclonic seizures, but reports of LEV toxicity are scarce. Here, we report a rare case of multifocal myoclonus due to LEV toxicity in a patient with chronic renal insufficiency. Case presentation A 52-year-old woman with history of chronic kidney disease was admitted to the ICU for sedation and intubation after a cardiac arrest. She developed nonconvulsive status epilepticus that resolved after administration of propofol while receiving LEV 1500 mg twice a day. After holding the propofol infusion, the patient started having multifocal myoclonic jerks, documented on video-EEG recordings with a supratherapeutic level of LEV. After discontinuation of LEV, the myoclonus resolved. Conclusion This is a unique manifestation of LEV toxicity, which has been scarce in the literature. It suggests an inverted U-shaped dose–response of the antimyoclonic effect of LEV. |
| Databáze: | OpenAIRE |
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