Epileptic Disorders


Antimyoclonic effect of levetiracetam Volume 2, issue 4, Décembre 2000


  • Antimyoclonic effect of levetiracetam
Centre Saint-Paul, 300, boulevard Saint-Marguerite, 13009 Marseille, France.

Treatment of severe, incapacitating action myoclonus is difficult. Piracetam has been shown to be a very potent antimyoclonic agent, but only at very high, impractical doses, ranging from 24 to 40 g/d. Levetiracetam (LEV), a new antiepileptic drug, is a structurally related compound that has a distinct pharmacological profile and appears to be efficient at much lower doses. We gave LEV, 4,000 mg/d, without titration, to three volunteers with post-anoxic myoclonus (PAM) (one case) and Unverricht-Lundborg disease (two cases), over 2, 2 and 10 weeks, respectively. LEV produced a clear abatement of myoclonus, which is demonstrated on video for the patient with post-anoxic myoclonus, without any unwanted side-effects. These preliminary findings suggest that LEV may have interesting antimyoclonic properties that deserve further investigation.Myoclonus may occur in various neurological disorders, including many forms of epilepsy, and often appears as a debilitating symptom. Piracetam (PIR) is effective in the treatment of many forms of myoclonus, especially in cortical myoclonus [1, 2], but high, impractical doses of up to 40 g/d are necessary [3]. Levetiracetam (LEV), a compound with a chemical structure that is closely related to that of PIR, has a different pharmacological profile [4] and is a potent new antiepileptic drug (AED) that is effective in human focal epilepsies and against generalized tonic-clonic seizures (GTCS) [5, 6] and has also shown promising efficacy in animal models of generalized epilepsies [7-9]. It was also shown to be effective in preventing the photoparoxysmal response in patients with photosensitive epilepsy [10], which may predict efficacy in generalized epilepsies and myoclonus. We thus decided to publish these case reports on the efficacy of LEV in the treatment of severe action myoclonus.