Encephalopathy induced by levetiracetam in an elderly woman

Hommet, Caroline; Beaufils, É.; Roubeau, Vincent; Toffol, Bertrand de; Ripault, Héliette; Constans, T.; Mondon, Karl

doi:10.1007/s40520-013-0009-x

Cited by 6 publications

(1 citation statement)

References 13 publications

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“…She had no renal failure, no concomitant valproate medication, and no other additional comorbidities. 8 An 80-year-old woman with levothyroxine-treated hypothyroidism had developed acute confusion and paranoia after five days of substituting levetiracetam 1000 mg orally twice daily for phenytoin 100 mg orally twice daily to control new-onset, generalized seizures. Before starting levetiracetam, results of the patient's blood and urine tests, brain magnetic resonance imaging and cerebrospinal fluid examination were within normal limits.…”

Section: Discussionmentioning

confidence: 99%

Levetiracetam as a cause of delirium in elderly patient: A case report

kasim¹,

Indu²,

Jayaprakashan³

et al. 2019

KJP

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Levetiracetam is a second-generation anticonvulsant. Delirium is not a well-known adverse effect of the drug. We present the report of an 80-year-old woman with a history of schizophrenia for 45 years and memory impairment for two years, who presented with worsening of confused, disoriented behaviour with sundowning, after being started on Tab. Levetiracetam for late-onset seizures. Examination revealed disorientation, fluctuation in the level of consciousness, impaired attention and psychotic symptoms. Physical examination was normal, except for gait disturbance. Relevant blood, urine and CSF investigations were also normal. Neuroimaging showed diffuse atrophy and small vessel ischemic changes. No focus of infection or metabolic imbalances could be identified. The possibility of delirium due to levetiracetam was suspected and, on cross-titration with sodium valproate, her delirium cleared. This report highlights that levetiracetam can cause delirium in the elderly, which brings forth the need for close monitoring while prescribing medicines in this population.

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Section: Discussionmentioning

confidence: 99%