Incecik Faruk, Herguner Ozlem M, Besen Seyda
Division of Child Neurology, Department of Pediatrics, Cukurova University Faculty of Medicine, Adana, Turkey.
J Pediatr Neurosci. 2020 Apr-Jun;15(2):81-85. doi: 10.4103/jpn.JPN_133_18. Epub 2020 Jun 27.
Levetiracetam (LEV) is a widely used antiepileptic drug (AED) in the treatment of various type of seizures, including generalized epileptic seizure as well as focal seizures, and it is generally well tolerated. Common side effects of LEV are somnolence, asthenia, dizziness, mood changes, kidney dysfunction, minor infections, and thrombocytopenia. Recently, increased creatine phosphokinase (CPK) concentration or rhabdomyolysis after LEV administration has been reported. The goal of the study was to evaluate clinical risk factors associated with increased CPK concentration or rhabdomyolysis in LEV administration.
One hundred and sixty children were enrolled. The risk factors were retrospectively analyzed.
Among the 160 patients, 84 (52.5%) were boys and 76 (47.5%) were girls, and the mean age was 85.95 ± 49.03 months (9-188 months). Of the 160 patients, 66 (41.3%) were treated with monotherapy, and 94 (58.8%) with polytherapy. We detected increased CPK concentration or rhabdomyolysis in three patients (1.9%). The CPK values of these three patients were 943, 1504, and 5046, respectively. No significant differences were observed in the serum CPK concentration between the patients treated with LEV.
We detected that LEV may cause increased CPK concentration or rhabdomyolysis. When treating patients with LEV, clinicians should closely monitor serum CPK level. To the best of our knowledge, this is the first study of elevated CPK concentration or rhabdomyolysis associated with LEV therapy in children.
左乙拉西坦(LEV)是一种广泛用于治疗各种类型癫痫发作的抗癫痫药物(AED),包括全身性癫痫发作和局灶性癫痫发作,并且通常耐受性良好。LEV的常见副作用包括嗜睡、乏力、头晕、情绪变化、肾功能障碍、轻微感染和血小板减少症。最近,有报道称服用LEV后肌酸磷酸激酶(CPK)浓度升高或发生横纹肌溶解。本研究的目的是评估与服用LEV后CPK浓度升高或横纹肌溶解相关的临床危险因素。
纳入160名儿童。对危险因素进行回顾性分析。
160例患者中,男孩84例(52.5%),女孩76例(47.5%),平均年龄为85.95±49.03个月(9 - 188个月)。160例患者中,66例(41.3%)接受单药治疗,94例(58.8%)接受联合治疗。我们在3例患者(1.9%)中检测到CPK浓度升高或横纹肌溶解。这3例患者的CPK值分别为943、1504和5046。服用LEV的患者之间血清CPK浓度未观察到显著差异。
我们检测到LEV可能导致CPK浓度升高或横纹肌溶解。在使用LEV治疗患者时,临床医生应密切监测血清CPK水平。据我们所知,这是第一项关于儿童LEV治疗相关CPK浓度升高或横纹肌溶解的研究。