levetiracetam and Spasm

A randomized, double-blind, placebo-controlled, crossover, multicenter trial. A 1-week baseline period was followed by two treatment periods of 5 weeks duration with levetiracetam increased from 500 mg b.i.d. to a maximum of 1500 mg b.i.d. separated by a 1-week washout period.. The objective of the study was primarily to evaluate the efficacy of the anticonvulsant levetiracetam in patients with spinal cord injury (SCI) at- and below-level pain and secondarily to evaluate the effect on spasm severity.. Outpatients at two spinal cord units and a pain center.. Patients were allowed to continue their usual pain treatment at a constant dose. The primary outcome measure was the change in median daily pain score (on a 0-10 point numeric rating scale) from 1-week baseline period to the last week of each treatment period. Secondary outcome measures included pain relief of at- and below-level pain, allodynia, spasms and spasticity.. A total of 36 patients with SCI at- and or below-level pain were enrolled. Of these, 24 patients completed the trial. We found no effect of levetiracetam on the primary (P=0.46) or any of the secondary outcome measures. Only two patients continued levetiracetam treatment following the trial, and one patient was still in levetiracetam treatment at the 6-month follow-up. Levetiracetam was generally well tolerated with no serious adverse events.. Levetiracetam does not relieve neuropathic pain or spasm severity following spinal cord injury.

Topics: Adult; Afferent Pathways; Aged; Analgesics; Anticonvulsants; Cross-Over Studies; Double-Blind Method; Female; Humans; Levetiracetam; Male; Middle Aged; Outcome Assessment, Health Care; Pain Measurement; Pain, Intractable; Parasympatholytics; Piracetam; Spasm; Spinal Cord; Spinal Cord Injuries; Treatment Failure

We studied the effects of oral levetiracetam (LEV) (500 mg twice daily) in three women with stiff-person syndrome in a single-blind, placebo-controlled study. The severity of muscle rigidity and of paroxysmal symptoms was assessed by EMG and clinically by a rating scale of 0-4 and by the Patients Global Impressions Scale. LEV was well tolerated. On active treatment all patients improved as assessed by any of the objective or subjective outcome measures. No response was noticed on placebo. Our data indicate that in patients with SPS, LEV is well tolerated and has a therapeutic role in the management of both muscle stiffness and life-threatening paroxysmal respiratory spasms.

Topics: Aged; Anticonvulsants; Electromyography; Female; Humans; Levetiracetam; Middle Aged; Muscle Rigidity; Muscle, Skeletal; Neurologic Examination; Piracetam; Respiration; Single-Blind Method; Spasm; Stiff-Person Syndrome

Topics: Aged; Antineoplastic Agents; Brain Neoplasms; DNA-Binding Proteins; Female; Frontal Lobe; Humans; Immunocompetence; Levetiracetam; Lymphoma; Magnetic Resonance Imaging; Nootropic Agents; Piracetam; Proto-Oncogene Proteins c-bcl-2; Proto-Oncogene Proteins c-bcl-6; Spasm