Fujikawa Mayu, Kishimoto Yuri, Kakisaka Yosuke, Jin Kazutaka, Kato Kazuhiro, Iwasaki Masaki, Nakasato Nobukazu
Department of Epileptology, Tohoku University School of Medicine, Sendai, Miyagi, Japan.
Department of Epileptology, Tohoku University School of Medicine, Sendai, Miyagi, Japan
J Child Neurol. 2015 Jun;30(7):942-4. doi: 10.1177/0883073814541471. Epub 2014 Jul 9.
A novel antiepileptic drug, levetiracetam, has been reported to cause several psychiatric adverse effects in spite of its effectiveness on epilepsy. However, a possible relationship between levetiracetam and obsessive-compulsive behavior has only been reported in a few studies with adult epilepsy patients. We treated a pediatric patient with epilepsy without past or family history of psychiatric disorder. Levetiracetam was started to control generalized tonic-clonic seizure. Two months after initiation of levetiracetam with favorable seizure control, she started to show an obsessive-compulsive behavior such as repetitive checking of her back, pants, and chair. Based on the course of its appearance, levetiracetam administration was identified as a possible cause. After termination of levetiracetam, her obsessive-compulsive behavior completely disappeared with reappearance of seizures. This case provides clear evidence that levetiracetam may cause obsessive-compulsive behavior even in a pediatric epilepsy patient without psychiatric background, possibly mediated by modulation of the glutamate system by levetiracetam.
据报道，新型抗癫痫药物左乙拉西坦尽管对癫痫有效，但会引起多种精神方面的不良反应。然而，仅在少数针对成年癫痫患者的研究中报道了左乙拉西坦与强迫行为之间可能存在的关系。我们治疗了一名无精神疾病既往史或家族史的癫痫患儿。开始使用左乙拉西坦来控制全身强直阵挛性发作。在开始使用左乙拉西坦且癫痫发作得到良好控制两个月后，她开始表现出强迫行为，如反复检查自己的背部、裤子和椅子。根据其出现的过程，确定服用左乙拉西坦可能是一个原因。停用左乙拉西坦后，她的强迫行为完全消失，癫痫发作再次出现。该病例提供了明确的证据，表明左乙拉西坦即使在没有精神疾病背景的小儿癫痫患者中也可能导致强迫行为，这可能是由左乙拉西坦对谷氨酸系统的调节介导的。
