levetiracetam and Polyneuropathies

Levetiracetam is an anticonvulsant which is assumed to act by modulating neurotransmitter release via binding to the vesicle protein SV2A. This could have an impact on signaling in the nociceptive system, and a pilot study indicated relief of neuropathic pain with levetiracetam.. The aim of this study was to test the analgesic effect of levetiracetam in painful polyneuropathy.. This was a randomized, double-blind, placebo-controlled, cross-over trial with levetiracetam 3000 mg/day versus placebo (6-week treatment periods). Patients with diagnosed polyneuropathy and symptoms for more than 6 months, age between 20 and 80 years, pain intensity of more than 4 on a 0-10-point numeric rating scale, and pain at least 4 days a week were included in the study. The primary outcome measure was pain relief at the end of each treatment period as measured on a 6-point verbal scale.. Ninety-three patients were screened for participation and 39 patients entered the study. Thirty-five patients were included in the data analysis. There were no differences in the ratings of pain relief (levetiracetam 2.29 versus placebo 2.28, p=0.979), total pain intensity (levetiracetam 5.5 versus placebo 5.3, p=0.293) or any of the other outcome measures (p=0.147-1.00).. This study indicates that the anticonvulsant levetiracetam has no clinically relevant effect on painful polyneuropathy.

Topics: Adult; Aged; Anticonvulsants; Cross-Over Studies; Double-Blind Method; Female; Humans; Levetiracetam; Male; Middle Aged; Neuralgia; Pain Measurement; Piracetam; Polyneuropathies; Treatment Outcome

Topics: Anticonvulsants; Antihypertensive Agents; Antineoplastic Agents; Biomarkers, Tumor; Bortezomib; Brain; Disease Management; Disease Progression; Female; Humans; Immunoglobulin kappa-Chains; Levetiracetam; Magnetic Resonance Imaging; Middle Aged; Multiple Myeloma; Neurologic Examination; Nimodipine; Nootropic Agents; Oligopeptides; Piracetam; Polyneuropathies; Posterior Leukoencephalopathy Syndrome; Secondary Prevention; Seizures

ABSTRACT Critical illness polyneuropathy (CIP) is a common complication in long (≥1 week) critical/intensive care hospitalizations. Rapidly progressing atrophy and weakness of the limb, trunk and, particularly, respiratory muscles may lead to severe morbidity or mortality. The aim of the present study was to investigate the protective effects of levetiracetam (LEV) on CIP in the early stage of sepsis in rats. We simulated CIP by a surgically induced sepsis model and verified it by lower-limb electromyography (EMG) (amplitude and duration of CMAP, and distal latency). We evaluated the effects of various doses of LEV treatment (300, 600, and 1200 mg/kg i.p.) on CIP by performing electrophysiology, and determining plasma tumor necrosis factor (TNF)-α, lipid peroxides (malondialdehyde, MDA) levels, and total antioxidant capacity (TAC). Our data showed: (1) significant suppression of CMAP amplitude and prolongation of distal latency in the saline-treated sepsis group, and distal latency as well as CMAP amplitudes benefiting best from the 600 mg/kg LEV treatment; (2) significant rise in plasma TNF-α and MDA levels in the saline-treated sepsis group, but significant ameliorations by the 600 and 1200 mg/kg LEV treatment; (3) highly significant suppression of TAC in the saline-treated group, but profound reversals in all LEV-treated groups. We conclude that 300, 600, and 1200 mg/kg i.p. doses of post-septic treatment by LEV has possibly acted in a dose-dependent manner to both protect and restore the affected peripheral nerves' axon and myelin following surgical disturbance of the cecum to induce sepsis and consequent polyneuropathy.

Topics: Action Potentials; Animals; Antioxidants; Electromyography; Levetiracetam; Male; Malondialdehyde; Muscles; Piracetam; Polyneuropathies; Rats; Rats, Sprague-Dawley; Sepsis; Tumor Necrosis Factor-alpha