Detailed contribution information
| Contribution title | 3286 - Psychotic symptoms associated with levetiracetam in children with epilepsy: report of three cases |
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| Contribution code | PS01-73 (P) |
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| Form of presentation | Poster |
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| Abstract |
Objectives: The purpose of this study was to report and discuss the occurrence of psychotic symptoms in three children and adolescents with seizures treated with levetiracetam. Methods: We report three cases of children with acute onset of psychotic symptoms (behavior disorders, delusions, auditory or visual hallucinations) after initiation of levetiracetam (LEV). Results: All three patients with tonico-clonic generalized epilepsy were girls aged from 9 to 14 years. Two patients had been on LEV in combination with others antiepileptic drugs for resistant epilepsy. The other patient was initiated with LEV monotherapy. Others anticonvulsivant drugs were stopped in this patient because of occurrence of side effects. The patient who received LEV monotherapy is a 14 years’ old girl. She displayed visual and auditory hallucinations, acute agitation and insomnia within two days after LEV initiation. She was treated with an initial dose of 250 mg twice a day(10 mg/kg/day). The second patient is a 9years’ old girl who had a history of mild mental retardation and resistant epilepsy. She was treated with sustained-release formulation of valproate (25mg/kg/day), clonazepam (0.066mg/kg/day). LEV was introduced in combination with these latter, started at 250 mg per day (10mg/kg/day) with good tolerance. When increasing doses to 20mg/kg/day, psychotic symptoms have settled acutely: agitation, hetero aggressive behavior, unmotivatedlaughing, crying and soliloquy. None of these two patients had previous psychotic disorders. The third patient was 10 years’ old, she has 8 years history of drug-resistant epilepsy. LEV was started at the age of two years in adjunction to clonazepam and lamotrigin. This patient suffered from a pervasive developmental disorder not otherwise specified in accordance to DSM IV criteria; symptoms worsened with increasing doses of LEV: with worsened impoverishment in social interactions and new symptoms like odd speech and behavior. Conclusion: LEV is associated with psychotic symptoms in our three patients. Whether prior neuropsychological problems of these patients or side effects of LEV predispose to psychotic symptoms is not established. Few cases of levetiracetam-induced psychosis in children are reported in the literature.The present study emphasizes the need for close monitoring of children on LEV. |