Parkinson’s Disease Worsens After Levetiracetam Use: A Rare case Report
A 77-year-old woman in Saudi Arabia experienced a significant worsening of her Parkinson’s disease symptoms after being prescribed the anti-seizure medication levetiracetam, according to a recent case report. The findings, published in Oxford Medical Case Reports, highlight the potential risks of using this medication in patients with Parkinson’s.
The woman,who had been living with Parkinson’s for over a decade,was prescribed levetiracetam to prevent seizures after a fall that caused her to lose consciousness for two minutes.However, shortly after starting the medication, her neurological and motor functions deteriorated. Once levetiracetam was discontinued, her condition improved.
“The use of Levetiracetam in patients with Parkinson’s disease can rarely lead to acute exacerbation of Parkinson’s symptoms and worsening of outcome,” the researchers noted.“Close monitoring of patients with Parkinson’s disease is recommended when prescribing anti-epileptics.”
Understanding Parkinson’s Disease
Parkinson’s disease is a neurodegenerative disorder characterized by the progressive loss of dopamine-producing nerve cells in the brain. This leads to a range of motor symptoms,such as tremors,rigidity,and bradykinesia,as well as nonmotor symptoms like cognitive decline and mood disorders.
How Levetiracetam Works
Levetiracetam, approved in the U.S. for treating certain types of epilepsy, works by binding to a brain protein called synaptic vesicle protein 2A.This interaction modulates the release of neurotransmitters, including dopamine. While some studies have explored its potential to alleviate dyskinesia—involuntary movements caused by levodopa treatment—results have been inconsistent. In some cases, the medication has been found to worsen Parkinson’s symptoms.
The case in Detail
The patient in this case had her parkinson’s well controlled with a regimen of levodopa/carbidopa. After her fall, a physical examination revealed she was fully alert and responsive, with a Glasgow Coma Scale (GCS) score of 15 out of 15. the only notable finding was cogwheel rigidity, a hallmark of Parkinson’s.
Brain imaging showed signs of diffuse subarachnoid hemorrhage, prompting the prescription of levetiracetam. However, the medication led to a rapid decline in her condition.
Key Takeaways
This case underscores the importance of cautious medication management in patients with Parkinson’s disease. While levetiracetam is effective for controlling seizures, its impact on Parkinson’s symptoms can be unpredictable.
| Key Points | Details |
|————————————|—————————————————————————–|
| Patient Profile | 77-year-old woman with Parkinson’s disease |
| Medication | Levetiracetam prescribed for seizure prevention |
| Outcome | Worsening of Parkinson’s symptoms; improvement after discontinuation |
| suggestion | Close monitoring of parkinson’s patients on anti-epileptic medications |
For more insights into Parkinson’s disease and its treatment, visit Parkinson’s News Today.This case serves as a reminder that even well-established medications can have unexpected effects, particularly in patients with complex neurological conditions. Always consult healthcare professionals for personalized treatment plans.A recent case study highlights the potential risks of using levetiracetam, a common anti-seizure medication, in patients with Parkinson’s disease. The findings suggest that this drug may exacerbate Parkinson’s symptoms, raising concerns about its use in this vulnerable population.
The case involved a woman who experienced extensive bleeding in the space surrounding her brain, a condition that can lead to epilepsy. To prevent seizures, clinicians prescribed levetiracetam. Though, four days later, her Glasgow Coma Scale (GCS) score dropped to 9 out of 15, indicating a significant decline in neurological function. She also exhibited worsening Parkinson’s motor symptoms, including muscle weakness, progressive stiffness, tremor, and overactive reflexes.
An electroencephalogram (EEG), which measures brain electrical activity, showed no signs of seizures, and other brain imaging studies appeared normal. After ruling out other potential causes of her Parkinson’s exacerbation, doctors gradually discontinued levetiracetam. This decision led to remarkable improvements: her muscle stiffness, tremors, and other neurological changes resolved, and she was discharged from the hospital.
The researchers emphasized that “an alternative anti-seizure agent can be considered in patients with Parkinson’s Disease.” However, they also noted that manny anti-epileptic medications have been linked to Parkinson’s development or worsening symptoms, complicating treatment decisions.
One promising alternative is zonisamide, sold as Zonegran in the U.S. Clinical studies suggest it is well-tolerated by Parkinson’s patients and may even ease Parkinson’s motor symptoms.Approved in Japan under the brand name Trerief as an add-on therapy as 2009, zonisamide offers a potential solution for those requiring seizure prevention.
“Hence, it is plausible that the administration of this treatment may yield favorable outcomes in individuals diagnosed with Parkinson’s disease who … necessitate the use of antiepileptic medications for … seizure prevention,” the researchers concluded.
Key Takeaways
| Medication | Impact on Parkinson’s | Recommendation |
|———————–|———————————————–|————————————————|
| Levetiracetam | May exacerbate motor symptoms | Consider alternatives |
| Zonisamide (Zonegran) | Well-tolerated; may ease motor symptoms | Promising option for seizure prevention |
This case underscores the importance of carefully selecting anti-epileptic medications for Parkinson’s patients. For more insights into managing Parkinson’s symptoms, explore our detailed guide on tremor management and the latest advancements in Parkinson’s therapies.
