title: Levetiracetam for cerebellar tremor in multiple sclerosis: an open-label pilot tolerability and efficacy study.
abstract: OBJECTIVE
  Disabling tremor is frequent in multiple sclerosis (MS) and its treatment remains challenging. We conducted an open-label trial to evaluate the effect of levetiracetam (LEV) to treat cerebellar tremor in MS patients.
  
  
  METHODS
  Fourteen MS patients, aged 27 to 57 years, with cerebellar tremor. Tremor duration ranged from 3 to 14 years. The tremor clinical rating scale, the spiral drawings scale, and ataxia clinical scale were used to assess the severity of tremor. Data about the tremor-induced disability were obtained by using the specific Activities of Daily Living Questionnaire (ADL). LEV was orally administered at a starting dose of 500 mg twice daily for one week followed by increments of 500 mg twice daily each week up to the target dose of 50 mg/Kg/day. Patients were evaluated at baseline and two weeks after the end of titration phase. The Wilcoxon matched-pairs test was used for statistical analysis.
  
  
  RESULTS
  Eleven patients completed the trial. LEV administration was associated with subjective and objective improvement of the tremor, with significant lowering of all tremor measurements' sum of scores as well as of ADL mean score between the baseline and follow-up. No correlation was found between the degree of improvement of the tremor and the disease duration or progression. LEV was well tolerated by subjects who completed the study.
  
  
  CONCLUSIONS
  LEV could be useful for the management of cerebellar tremor in MS and the good tolerability makes it easy to test. LEV long-term efficacy should be confirmed in extended studies.
authors: Department of Neurological Sciences, Federico II University, Via Pansini 5, 80131 Naples, Italy. sstriano@libero.it
authors: Pasquale
authors: P
authors: Striano
authors: Antonietta
authors: A
authors: Coppola
authors: Giovanni
authors: G
authors: Vacca
authors: Federico
authors: F
authors: Zara
authors: Vincenzo
authors: V
authors: Brescia Morra
authors: Giuseppe
authors: G
authors: Orefice
authors: Salvatore
authors: S
authors: Striano