Antimyoclonic effect of levetiracetam in 13 patients with Unverricht-Lundborg disease: clinical observations.
OBJECTIVE
Disabling myoclonus is the main symptom in long-standing Unverricht-Lundborg disease (ULD), and levetiracetam (LEV) appears to be an effective anticonvulsant with promising short-term antimyoclonic properties.


METHODS
LEV was prescribed to 13 patients with ULD. We retrospectively analyzed the efficacy of LEV on seizure frequency and on myoclonus, by using a simplified myoclonus rating score, and compared the patients' status before LEV and at the last follow-up. They were two women and 11 men, aged 14 to 52 years (mean, 36.5 years), with a disease duration of 4 to 40 years (mean, 24.3 years). LEV was given at 2,000 to 4,000 mg/d for 0.5 to 26 months (mean, 13.8 months).


RESULTS
One patient stopped LEV within 2 weeks because of side effects and lack of efficacy. None of the other 12 patients reported side effects. The average myoclonus score significantly changed from 3.1 to 2.4 (p = 0.01), but only eight had a measurable improvement.


CONCLUSIONS
The best effects were noted in the younger patients. In patients previously treated with high-dose piracetam (PIR), discontinuation of PIR was not always well tolerated, and a combination of PIR at lower doses and LEV appeared to be a practical solution. LEV should probably be considered as a major treatment option early in the course of ULD.
Magaudda
Adriana
A
Center for Diagnosis and Care of Epilepsy, University of Messina, Italy. adriana.magaudda@libero.it
Gelisse
Philippe
P
Genton
Pierre
P
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000927:Anticonvulsants / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D000077287:Levetiracetam; D008297:Male; D008875:Middle Aged; D009207:Myoclonus / Q000175:diagnosis / Q000188:drug therapy* / Q000517:prevention & control; D010889:Piracetam / Q000031:analogs & derivatives / Q000627:therapeutic use*; D016896:Treatment Outcome; D020194:Unverricht-Lundborg Syndrome / Q000175:diagnosis / Q000188:drug therapy*
D000927:Anticonvulsants; D000077287:Levetiracetam; D010889:Piracetam