Levetiracetam in patients with cortical myoclonus: A clinical and electrophysiological study

Pasquale Striano, Fiore Manganelli, Patrizia Boccella, Anna Perretti, Salvatore Striano

Research output: Contribution to journalArticle

Abstract

Levetiracetam is a new antiepileptic agent that exerts alimyoclonic effects. We conducted an open-label trial to evaluate the effect of levetiracetain in chronic cortical myoclonus of diverse etiologies and to determine whether levetiracetam affects electrophysiological findings. Sixteen patients, aged between 19 and 72 years, with refractory, chronic, cortical myoclonus were recruited. We assessed myoclonus severity with the Unified Myoclonus Rating Scale (UMRS). The electrophysiological study comprised jerk-locked averaging, somatosensory evoked potentials (SEPs), and long loop reflex I. Levetiracetam was administered add-on at a starting dose of 500 mg twice per day up to the target dose of 50 mgIkgIday. Patients were reevaluated clinically and electrophysiologically 2 weeks after the titration phase. Fourteen patients completed the trial. Posttreatment UMRS scores showed an improvement of myoclonus in all cases. Pretreatment, 9 patients had "giant" SEPs. Posttreatment, the amplitude of these SEPs was reduced by more than 50% in 3 of 9 patients, and the mean N20-P25 amplitude was reduced significantly. Pre-and posttreatment SEP amplitude was not related to myoclonus severity or duration. Levetiracetam is a promising and a relatively easy-to-test antimyoclonic agent, which has the potential to improve significantly the patient's disability; however, its long-term efficacy should be verified in larger controlled studies.

Original languageEnglish
Pages (from-to)1610-1614
Number of pages5
JournalMovement Disorders
Volume20
Issue number12
DOIs
Publication statusPublished - Dec 2005

Keywords

  • Cortical myoclonus
  • Electrophysiology
  • Levetiracetam
  • SEPs

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

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