服用左乙拉西坦后帕金森病病情加重：一种不寻常的现象。

Parkinson's disease exacerbation following Levetiracetam administration: an unusual phenomenon.

作者信息

Alqahtani Laila, Alkhaibary Ali, Bouhouf Farid

机构信息

College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.

King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.

出版信息

Oxf Med Case Reports. 2025 Jan 18;2025(1):omae174. doi: 10.1093/omcr/omae174. eCollection 2025 Jan.

DOI:10.1093/omcr/omae174

PMID:39839697

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11748458/

Abstract

BACKGROUND

Several studies have investigated the potential beneficial and side effects of levetiracetam on Parkinson's disease (PD). We hereby report a case of PD exacerbation following Levetiracetam administration for seizure prophylaxis.

CASE DESCRIPTION

A 77-year-old female, known to have PD, presented with a head injury following a fall. Brain CT showed diffuse subarachnoid hemorrhage. The patient was started on Levetiracetam for seizure prophylaxis. Four days after, the patient dropped GCS from 15 to 9. She was having progressive exacerbation of Parkinson's disease symptoms. After ruling out all possible causes of PD exacerbation, Levetiracetam was gradually weaned until it was discontinued. Consequently, the patient had rapid significant clinical improvement after discontinuation of Levetiracetam.

CONCLUSION

The use of Levetiracetam for seizure prophylaxis in patients with PD can rarely lead to acute exacerbation of symptoms and worst outcome. Close monitoring of patients with PD is recommended when prescribing anti-epileptics.

摘要

背景

多项研究探讨了左乙拉西坦对帕金森病（PD）的潜在益处和副作用。我们在此报告一例在使用左乙拉西坦预防癫痫发作后帕金森病加重的病例。

病例描述

一名77岁的女性，已知患有帕金森病，因跌倒导致头部受伤。脑部CT显示弥漫性蛛网膜下腔出血。患者开始使用左乙拉西坦预防癫痫发作。四天后，患者格拉斯哥昏迷评分（GCS）从15降至9。她的帕金森病症状逐渐加重。在排除帕金森病加重的所有可能原因后，左乙拉西坦逐渐减量直至停用。结果，停用左乙拉西坦后患者临床症状迅速显著改善。