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[Paradoxical effect of levetiracetam on seizure suppression: three cases showing U curve association between dose and effect]
- Source :
- Rinsho shinkeigaku = Clinical neurology. 61(4)
- Publication Year :
- 2021
-
Abstract
- We experienced 3 adult patients with intractable focal epilepsy treated by levetiracetam (LEV) as polytherapy, who showed paradoxical effect (PE). Starting dose of LEV was small (62.5, 250 mg/day) and we gradually increased by less than 250 mg/day, every more than 2 weeks. Within 6 months after LEV was added, LEV of 750 to 1,000 mg/day brought reduction of seizure frequency. Serum concentration of LEV was 13.3 and 14.0 μg/ml. In order to obtain better seizure control, LEV was increased up to 1,000-2,500 mg/day (19.3-35.0 μg/ml) within one year, and they developed PE. They all showed increased habitual seizures, occurring in cluster. Once dose of LEV deceased down to what produced the maximum seizure suppression, all of the patients regained the better seizure control. It is most likely that at least in some patients like present 3 cases, PE of LEV may express U curve association between dose and effect and that it was only delineated by slow titration.
- Subjects :
- Adult
Male
Levetiracetam
03 medical and health sciences
Epilepsy
0302 clinical medicine
Seizures
Seizure control
Medicine
Humans
Seizure frequency
Adult patients
Dose-Response Relationship, Drug
business.industry
Electroencephalography
Serum concentration
medicine.disease
Magnetic Resonance Imaging
Seizure suppression
Treatment Outcome
Anesthesia
Anticonvulsants
Drug Therapy, Combination
Female
Neurology (clinical)
business
030217 neurology & neurosurgery
medicine.drug
Subjects
Details
- ISSN :
- 18820654
- Volume :
- 61
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Rinsho shinkeigaku = Clinical neurology
- Accession number :
- edsair.doi.dedup.....151a1e94eb730b810c2dbc7519558b5f