Publications

Levetiracetam is one of the most widely used antiseizure medications (ASMs) and is generally considered a relatively safe drug. Here, we report five cases of levetiracetam-induced parkinsonism (LIP) to raise awareness among physicians about this unusual adverse effect, which has not been reported in clinical trials. Patients who developed parkinsonism due to exposure to levetiracetam and were on stable drug regimens at the time of levetiracetam initiation were enrolled. All patients satisfied the following criteria for drug-induced parkinsonism: 1. presence of at least two of the four cardinal signs of parkinsonism – rest tremor, bradykinesia, rigidity, and postural imbalance; 2. symptoms beginning within 6 months of starting the offending drug; 3. no parkinsonian symptoms before introduction of the offending drug; and 4. symptom resolution within 6 months after discontinuing the offending drug.[1] Those on any other medications known to cause parkinsonism and those with any confounding factors that may precipitate subclinical parkinsonism, like septicemia, hyponatremia, or other metabolic derangements, were excluded. They underwent thorough history taking, neurologic evaluation, and magnetic resonance imaging (MRI) of the brain. We did not perform any functional imaging with positron emission tomography or single-photon emission computed tomography scans for dopamine uptake in our patients due to financial constraints and their unavailability in our hospitals. Informed consent was obtained from all patients. The study protocol was reviewed and approved by the institution’s ethics committee on May 2, 2024. Data were recorded using Excel™ and analyzed using appropriate descriptive statistics.