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Levetiracetam accumulation in renal failure causing myoclonic encephalopathy with triphasic waves

Iwanowski, Patricia
Jallon, Pierre
Published in Seizure. 2009, vol. 18, no. 5, p. 376-378
Abstract Triphasic waves are seen in the electro-encephalogram of adult patients with toxic-metabolic encephalopathies of various origins. Levetiracetam is a broad spectrum anti-epileptic drug with renal elimination and no hepatic metabolism. We describe the case of encephalopathy with triphasic waves concomitant with levetiracetam accumulation in a patient with chronic renal failure. The condition was reversible after down-titration of levetiracetam with no change of the renal function. Other causes of metabolic encephalopathy were excluded. Moreover, this patient suffered from a probable cortical myoclonus that relapsed after cessation of the drug but was well controlled by a low dosage adapted to the renal failure. In cases of metabolic encephalopathy with triphasic waves in a patient with renal failure taking levetiracetam, it is important to exclude toxic accumulation of levetiracetam among other causes.
Keywords Aged, 80 and overAnticonvulsants/*adverse effectsElectroencephalography/methodsEpilepsies, Myoclonic/chemically induced/*etiology/*physiopathologyFemaleHumansPiracetam/adverse effects/*analogs & derivativesRenal Insufficiency/*complications/*physiopathology
PMID: 19201620
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VULLIEMOZ, Serge et al. Levetiracetam accumulation in renal failure causing myoclonic encephalopathy with triphasic waves. In: Seizure, 2009, vol. 18, n° 5, p. 376-378. doi: 10.1016/j.seizure.2009.01.006 https://archive-ouverte.unige.ch/unige:20165

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Deposited on : 2012-04-23

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