levetiracetam and Meningitis--Aseptic

Topics: Humans; Levetiracetam; Meningitis, Aseptic; Meningitis, Viral

Levetiracetam (LEV) is a pyrrolidine derivative antiepileptic medication used for the treatment of seizures in pediatric and adult patients. We report a case of probable LEV-induced aseptic meningitis in a 13-year-old girl. The patient received LEV for a generalized seizure disorder and presented with symptoms 5 days after medication initiation. Ten days after LEV initiation, the patient presented to the hospital for further management. During her hospital course, infectious etiologies were ruled out with clinical and diagnostic testing. Upon discontinuation of LEV, the patient's symptoms resolved. Although select antiepileptic medications have been associated with drug-induced aseptic meningitis (DIAM), to date, no reports have been published about DIAM following the administration of LEV. We describe and categorize the probability of DIAM in association with LEV, as observed in a patient case.

Topics: Adolescent; Anticonvulsants; Epilepsy, Generalized; Female; Humans; Levetiracetam; Meningitis, Aseptic

Anticonvulsant hypersensitivity syndrome (AHS) is a rare, potentially life-threatening drug reaction which usually occurs after exposure to aromatic antiepileptics. AHS secondary to non-aromatic antiepileptics is even more rare and there are only few case reports of AHS presenting as aseptic meningitis. We present the case of a 48-year-old patient who presented with meningism within 3 weeks of adding lamotrigine for control of her juvenile myoclonic epilepsy. When lamotrigine was restarted 2 weeks later she developed similar but more severe symptoms which resolved on stopping lamotrigine. Our patient was subsequently rendered seizure free on levetiracetam which has not so far been linked with this syndrome. It is important to be aware of this life-threatening complication associated with the use of antiepileptics.

Topics: Anti-Bacterial Agents; Anticonvulsants; Drug Administration Schedule; Drug-Related Side Effects and Adverse Reactions; Female; Fever; Headache; Humans; Lamotrigine; Levetiracetam; Meninges; Meningitis, Aseptic; Middle Aged; Myoclonic Epilepsy, Juvenile; Nausea; Piracetam; Steroids; Triazines