levetiracetam and Lung-Neoplasms

It is well known that myoclonus can be a paraneoplastic manifestation of underlying malignancy.. A 78-year-old male diagnosed with papillary variant non-small cell lung cancer (NSCLC) presented with tremulousness that rapidly evolved into severe, diffuse myoclonus with prominent palatal involvement requiring intubation. The generalized myoclonus resolved with on levetiracetam, chemotherapy and immune modulation. While low titer positive P/Q type calcium channel autoantibodies were detected, it's etiologic relevance is unclear.. This case highlights a rare neurologic paraneoplastic presentation of papillary NSCLC. It also illustrates the importance of monitoring airway safety when myoclonus is generalized.. A new, rare paraneoplastic presentation of papillary variant non-small cell lung adenocarcinoma is described. The patient presented with severe diffuse myoclonus with prominent palatal involvement without encephalitis that responded to a combination of chemotherapy, immune modulation, and levetiracetam. No clear causal antibody was found.

Topics: Adenocarcinoma, Papillary; Aged; Anticonvulsants; Antineoplastic Combined Chemotherapy Protocols; Autoantibodies; Carboplatin; Carcinoma, Non-Small-Cell Lung; Dexamethasone; Humans; Intubation, Intratracheal; Levetiracetam; Lung Neoplasms; Male; Myoclonus; Palatal Muscles; Paraneoplastic Syndromes, Nervous System; Pemetrexed; Respiratory Aspiration

Adenoid cystic carcinoma (ACC) is a rare cancer, and there are no standard-of-care treatments for patients with metastatic ACC. We herein report a patient with lung metastasis of ACC who achieved a favorable response to levetiracetam. A 52-year-old Japanese man was admitted to our hospital because of multiple lung metastases of ACC. We performed first-line chemotherapy with cisplatin plus gemcitabine, and subsequently oral S-1 as second-line chemotherapy, which resulted in disease progression. The patient developed symptomatic epilepsy and received levetiracetam (250 mg twice daily). At five months after the initiation of levetiracetam, chest computed tomography showed regression of the metastatic lung lesions.

Topics: Anticonvulsants; Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Adenoid Cystic; Cisplatin; Deoxycytidine; Epilepsy; Gemcitabine; Humans; Levetiracetam; Lung Neoplasms; Male; Middle Aged; Piracetam; Tomography, X-Ray Computed

Brain metastases occur in about 30% of patients with non-small-cell lung carcinoma; seizures occur in approximately 20% of them. Antiepileptic drugs are commonly given for postoperative prophylaxis after brain or metastasis tumor surgery. The incidence of seizures following supratentorial craniotomy is estimated to be 15%-20%. Postoperative seizures are more common in the first month after cranial surgery. However, the use of antiepileptic drugs postoperatively has been investigated in randomized controlled trials. In case of seizures, the recommendations are continuing antiepileptic drugs after a 1- to 4-year seizure-free interval. This decision must weigh the risk of seizure recurrence against the possible benefits of the drug. Some antiepileptic drugs have been known to cause blood dyscrasias, including neutropenia, but this is a rare occurrence.. We report a case of neutropenia related to the use of levetiracetam at first exposure. After drug administration, neutropenia was detected. Additional tests were performed.. By exclusion, it was decided to withdraw the drug, and the patient had a reversal of neutropenia.. Levetiracetam-induced neutropenia is infrequent but possible. It is an exclusion diagnosis.

Topics: Adenocarcinoma; Anticonvulsants; Brain Neoplasms; Craniotomy; Drug Administration Schedule; Humans; Levetiracetam; Lung Neoplasms; Male; Middle Aged; Neutropenia; Piracetam; Seizures

A 60-year-old man presented with a 25-day history of acute onset instability of gait, tremulousness of limbs and involuntary eye movements. Examination revealed presence of opsoclonus, myoclonus and ataxia, without any loss of motor power in the limbs. Prompt investigations were directed towards identifying an underlying malignancy which is often associated with this type of clinical scenario. CT of the brain was normal and cerebrospinal fluid examination showed lymphocytic pleocytosis. A cavitatory lesion was found in the right lung base on the high-resolution CT of the chest and histopathological examination of this lung mass showed small cell lung carcinoma. The patient was managed symptomatically with levetiracetam and baclofen and referred to oncology department for resection of the lung mass.

Topics: Baclofen; Humans; Levetiracetam; Lung; Lung Neoplasms; Male; Middle Aged; Muscle Relaxants, Central; Opsoclonus-Myoclonus Syndrome; Piracetam; Radiography; Small Cell Lung Carcinoma