Saito Satoshi, Iijima Mutsumi, Ikeguchi Ryotaro, Ishizuka Kentaro, Kitagawa Kazuo
Department of Neurology, Tokyo Women's Medical University School of Medicine, Tokyo, JPN.
Cureus. 2023 Jul 10;15(7):e41666. doi: 10.7759/cureus.41666. eCollection 2023 Jul.
Rhabdomyolysis is a known side effect of levetiracetam. In general, a patient with rhabdomyolysis complains of muscle pain and swelling. Herein, we report four cases of asymptomatic levetiracetam-induced rhabdomyolysis. In all the four cases, the seizures resolved after more than five days. The patients received continuous fluid replacement from the time they were admitted to our hospital. However, serum creatine kinase (CK) levels continued to rise without symptoms consistent with rhabdomyolysis. The serum CK level improved rapidly when levetiracetam was replaced with lacosamide. Because levetiracetam occasionally causes asymptomatic rhabdomyolysis, routine blood tests should be performed after its initiation.
横纹肌溶解是左乙拉西坦已知的副作用。一般来说，患有横纹肌溶解的患者会抱怨肌肉疼痛和肿胀。在此，我们报告4例无症状的左乙拉西坦诱发的横纹肌溶解病例。在所有这4例病例中，癫痫发作在5天多后缓解。患者从入院时起就接受持续的液体补充。然而，血清肌酸激酶（CK）水平持续升高，且无与横纹肌溶解相符的症状。当用拉科酰胺替代左乙拉西坦后，血清CK水平迅速改善。由于左乙拉西坦偶尔会导致无症状性横纹肌溶解，因此在开始使用后应进行常规血液检查。
