ISSUE A novel mechanism of action has recently been described for levetiracetam, a member of a new class of anticonvulsants. Levetiracetam binds selectively and with high affinity to a synaptic vesicle protein known as SV2A, thought to be involved with synaptic vesicle exocytosis and presynaptic neurotransmitter release.

This study compared levetiracetam (Keppra) with reference antiepileptic drugs (AEDs) in the rat pilocarpine model of temporal lobe epilepsy. Electroencephalogram (EEG) recordings showed that i.p. administration of valproate (300 mg/kg), phenobarbital (5 mg/kg) and clonazepam (0.5 mg/kg) all significantly delayed the appearance of the first epileptic spike discharge in hippocampus as well as syn...

Levetiracetam is a novel antiepileptic drug which has recently been released as an adjunctive treatment for partial epilepsy. In the two studies reported here we examined the objective and subjective effects of levetiracetam on sleep in 12 healthy volunteers and 17 patients [16 who could be evaluated for electroencephalogram (EEG) recordings] with a history of partial epilepsy on stable carbama...

A 10-month-old girl was referred to our institution for evaluation of recurrent loss of consciousness that occurred for 30 seconds 1 to 3 times a day. The seizures occurred after crying, pain, or frustration. Because of toniclike seizures before the loss of consciousness, the girl was initially remitted to pediatric neurology, where a movieassisted electroencephalography was registered (Movie I...

Emerging data on the teratogenic potential of antiepileptic drugs (AEDs), in particular valproate, have resulted in a prescribing shift towards lamotrigine and levetiracetam in women of childbearing age with epilepsy. Over the last 20 years prescription of lamotrigine to women of childbearing potential has increased tenfold in the UK, with a reduction in valproate prescription of one third. How...

Lacosamide has been reported to have been successfully used for non-convulsive status epilepticus after benzodiazepine failure, and convulsive status epilepticus after benzodiazepine and levetiracetam failure. We report a case of simple motor status epilepticus refractory to benzodiazepines and multiple anti-epileptic medications (AEDs) over 4 days. The addition of lacosamide in combination wit...

Intractable epilepsy in children poses a serious medical challenge. Acute repetitive seizures and status epilepticus leads to frequent emergency room visits and hospital admissions. Delay of treatment may lead to resistance to the first-line anticonvulsant therapies. It has been shown that these children continue to remain intractable even after acute seizure management with approved Food and D...

Tourette syndrome is a common childhood-onset neuropsychiatric disorder characterized by chronic tics and frequent comorbid conditions such as attention deficit disorder. Most currently used tic-suppressing drugs are frequently associated with serious adverse events. Thus, alternative therapeutic agents with more favorable side-effect profiles are being evaluated. New hypotheses and recent stud...

Allergic reactions to antiepileptic drugs in the form of skin rash are not uncommon but angioedema, an acute life threatening reaction is rare. Angioedema has been reported with the use of oxcarbazepine and carbamazepine. We report a case of a 33-year-old woman with focal epilepsy who developed angioedema following levetiracetam monotherapy. The patient had previous skin rashes with both phenyt...

Pervasive developmental disorder is characterized by various symptoms that often include self-injurious behavior (SIB). Episodes of SIB occur in the context of high emotional arousal, anger, or fear and may be related to epilepsy. We report the case of a 20-year-old man with pervasive developmental disorder presenting with SIB non-responsive to antipsychotic medication. Positron emission tomogr...