Multifocal myoclonus as a presentation of levetiracetam toxicity

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 his...

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Autores principales:	Mei Bou Nasif, Shweta Varade, Mohamad Z. Koubeissi
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Levetiracetam Multifocal myoclonus Pharmacology Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571
Acceso en línea:	https://doaj.org/article/e14dbc7b46d04c72afd11431d863c17d
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spelling	oai:doaj.org-article:e14dbc7b46d04c72afd11431d863c17d2021-11-26T04:37:13ZMultifocal myoclonus as a presentation of levetiracetam toxicity2467-981X10.1016/j.cnp.2021.10.004https://doaj.org/article/e14dbc7b46d04c72afd11431d863c17d2021-01-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2467981X21000469https://doaj.org/toc/2467-981XBackground: 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.Mei Bou NasifShweta VaradeMohamad Z. KoubeissiElsevierarticleLevetiracetamMultifocal myoclonusPharmacologyNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571ENClinical Neurophysiology Practice, Vol 6, Iss , Pp 281-284 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Levetiracetam Multifocal myoclonus Pharmacology Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571
spellingShingle	Levetiracetam Multifocal myoclonus Pharmacology Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Mei Bou Nasif Shweta Varade Mohamad Z. Koubeissi Multifocal myoclonus as a presentation of levetiracetam toxicity
description	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.
format	article
author	Mei Bou Nasif Shweta Varade Mohamad Z. Koubeissi
author_facet	Mei Bou Nasif Shweta Varade Mohamad Z. Koubeissi
author_sort	Mei Bou Nasif
title	Multifocal myoclonus as a presentation of levetiracetam toxicity
title_short	Multifocal myoclonus as a presentation of levetiracetam toxicity
title_full	Multifocal myoclonus as a presentation of levetiracetam toxicity
title_fullStr	Multifocal myoclonus as a presentation of levetiracetam toxicity
title_full_unstemmed	Multifocal myoclonus as a presentation of levetiracetam toxicity
title_sort	multifocal myoclonus as a presentation of levetiracetam toxicity
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/e14dbc7b46d04c72afd11431d863c17d
work_keys_str_mv	AT meibounasif multifocalmyoclonusasapresentationoflevetiracetamtoxicity AT shwetavarade multifocalmyoclonusasapresentationoflevetiracetamtoxicity AT mohamadzkoubeissi multifocalmyoclonusasapresentationoflevetiracetamtoxicity
_version_	1718409872862609408

Multifocal myoclonus as a presentation of levetiracetam toxicity

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