levetiracetam and Oligodendroglioma

Treatment options for recurrent glioma of the brain include chemotherapy, radiotherapy, surgery, and palliation. Temozolomide appears to be effective in patients with recurrent high-grade gliomas.. A middle-aged woman presented with a high-grade glioma of corpus callosum. The tumor, a grade 3 anaplastic oligodendroglioma, was excised, and chemoradiotherapy was administered. The patient presented with significant recurrence 5 years later. Repeat surgery and radiation were suggested but refused. She was given temozolomide and dexamethasone intermittently, and levetiracetam was continued. Magnetic resonance imaging performed at 10-month follow-up showed 90% remission.. There are a few reports in the literature of similar response to temozolomide and levetiracetam. Similar reports give more hope in the treatment of recurrent high grade glioma.

Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Brain Neoplasms; Chemoradiotherapy; Corpus Callosum; Craniotomy; Dacarbazine; Decompression, Surgical; Dexamethasone; Female; Humans; Levetiracetam; Magnetic Resonance Imaging; Neoplasm Recurrence, Local; Oligodendroglioma; Piracetam; Remission Induction; Temozolomide; Tomography, X-Ray Computed

Levetiracetam may induce serious behavioral disturbances, especially after surgical resection of frontal lobe low-grade glioma. Two patients, treated with levetiracetam, developed serious psychiatric complications postoperatively which completely resolved after switching to valproate. We aim to create awareness for this serious but reversible adverse effect of levetiracetam in this specific patient category.

Topics: Anticonvulsants; Brain Neoplasms; Craniotomy; Epilepsy; Frontal Lobe; Humans; Levetiracetam; Magnetic Resonance Imaging; Male; Mental Disorders; Middle Aged; Oligodendroglioma; Piracetam; Postoperative Complications; Valproic Acid

We report on a case of epilepsia partialis continua with rapid response to intravenous bolus administration of levetiracetam. A 60-year-old woman presented with continuous jerking of the right foot and hallux persisting for more than two days. She had a 9-year history of epilepsy due to a left temporoparietal oligodendroglioma with occasional focal seizures clinically presenting as speech arrest, which was treated with levetiracetam and oxcarbazepine administered orally. After hospital admission, the twitching of the foot and toe was refractory to add-on treatment with lorazepam and diazepam but stopped within 15 min after intravenous bolus administration of 2000 mg levetiracetam. This observation suggests that intravenous bolus administration of levetiracetam may be an effective therapeutic option in epilepsia partialis continua.

Topics: Anticonvulsants; Brain Neoplasms; Epilepsies, Partial; Female; Humans; Injections, Intravenous; Levetiracetam; Middle Aged; Oligodendroglioma; Piracetam; Speech Disorders