Levetiracetam in idiopathic generalised epilepsy and porphyria cutanea tarda.
We report the case of a 50-year-old male patient with idiopathic generalised epilepsy and porphyria cutanea tarda. Valproic acid and phenobarbital monotherapy controlled seizures but exacerbated porphyric symptomatology, while clobazam, clonazepam and lamotrigine monotherapy were well tolerated as regards porphyric disturbances but did not completely control seizures. Tonic- clonic seizures were eventually controlled by a combination of clonazepam (9 mg/day) and lamotrigine (150 mg/day), but absences persisted and this treatment caused significant adverse effects consisting of sedation and memory disturbances. Levetiracetam monotherapy (3 g/day) was accompanied by complete control of seizures; memory disturbances and sedation also resolved, and no porphyrinogenetic activity of levetiracetam was observed. This is the first report of the safe use of levetiracetam in porphyria cutanea tarda.
Bilo
Leonilda
L
Department of Neurological Sciences, Epilepsy Center, Federico II University, Naples, Italy. ledabilo@fastwebnet.it
Meo
Roberta
R
Fulvia de Leva
Maria
M
D000284:Administration, Oral; D000927:Anticonvulsants / Q000008:administration & dosage / Q000627:therapeutic use; D002998:Clonazepam / Q000008:administration & dosage / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004830:Epilepsy, Tonic-Clonic / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D000077213:Lamotrigine; D000077287:Levetiracetam; D008297:Male; D008875:Middle Aged; D018697:Nootropic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D010889:Piracetam / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D017119:Porphyria Cutanea Tarda / Q000150:complications / Q000188:drug therapy*; D013997:Time Factors; D016896:Treatment Outcome; D014227:Triazines / Q000008:administration & dosage / Q000627:therapeutic use
D000927:Anticonvulsants; D018697:Nootropic Agents; D014227:Triazines; D000077287:Levetiracetam; D002998:Clonazepam; D000077213:Lamotrigine; D010889:Piracetam