Jayashankar Sharanya, Munakomi Sunil, Sayeerajan Vignesh, Kafle Prakash, Chaudhary Pramod, Thingujam Jagdishchandra, Poudel Deepak, Cherian Iype
Department of Neurosurgery, Nobel Medical College and Teaching Hospital, Biratnagar, 0977, Nepal.
F1000Res. 2019 Feb 15;8:187. doi: 10.12688/f1000research.18198.1. eCollection 2019.
Herein we report a rare case of acute liver failure due to levetiracetam, which has been considered to have an excellent safety profile with minimal hepatic side effects. A 55-year-old male patient presenting with sudden onset dizziness, slurring of speech and headache was operated for posterior fossa cerebellar hematoma. His post-surgical period was complicated by development of icterus with elevation of liver enzymes. After ruling out common inciting factors, it was decided to stop levetiracetam which was given prophylactically for preventing seizures owing to presence of external ventricular drain. From the next day patient had dramatic improvement in liver functions and sensorium. We would like to highlight this side effect that is potentially life threatening, though rare, of levetiracetam, which is very commonly used in today's practice and fast superseding all other time-tested antiepileptics.
在此，我们报告一例因左乙拉西坦导致急性肝衰竭的罕见病例，左乙拉西坦一直被认为具有良好的安全性，肝脏副作用极小。一名55岁男性患者因后颅窝小脑血肿接受手术，术后突然出现头晕、言语不清和头痛。他的术后出现黄疸，肝酶升高。排除常见诱发因素后，决定停用因存在外部脑室引流而预防性使用的左乙拉西坦以预防癫痫发作。从第二天起，患者的肝功能和意识状态有了显著改善。我们想强调左乙拉西坦这种虽罕见但可能危及生命的副作用，在当今的临床实践中左乙拉西坦被广泛使用，并且正在迅速取代所有其他经过长期考验的抗癫痫药物。
