Abstracts

RATIONALE: The progressive myoclonic epilepsies are a heterogeneous group of disorders typically comprising of myoclonus, epilepsy, cognitive impairment and progressive neurological impairment. Traditionally they are very difficult conditions to treat, and new therapies are needed. Levetiracetam is a new anticonvulsant licensed for use in refractory partial epilepsy. Its exact mode of action is unknown, although it is a structural analogue of piracetam. We hypothesized that it may be a useful drug in patients with progressive myoclonic epilepsy.
METHODS: A 30 year-old woman with progressive myoclonic epilepsy of the Unverricht-Lundborg type (Baltic myoclonus) was treated with levetiracetam, and her response was observed while being monitored in hospital at initiation of therapy.
RESULTS: The patient[ssquote]s condition began at the age of 13 and progressed steadily. Before introduction of levetiracetam, she had severe stimulus-evoked and action myoclonus, dysarthria, was wheelchair-bound and confined to her home. She had been treated with numerous anticonvulsants over the years with little success. She was commenced on 500 mg bd of levetiracetam, which was gradually increased to 1.5 g bd without adverse effects. Her myoclonus improved remarkably, her speech became significantly more intelligible, and she was able to walk with the aid of a rollator for the first time in eight years. Response was maintained at six months follow-up.
CONCLUSIONS: Levetiracetam may be a particularly useful drug for patients with progressive myoclonic epilepsy, and help to improve seizure control and enhance quality of life.
Support: Nil.