title: Open-label pilot trial of levetiracetam for cramps and spasticity in patients with motor neuron disease.
abstract: Cramps and spasticity impair quality of life and function in patients with motor neuron diseases, and there are no proven treatments for these problems. We conducted a pilot trial to determine if treatment with levetiracetam was associated with a reduction in cramp severity, cramp frequency, tonic or phasic spasticity. We used an open-label repeated measures pilot trial of 20 patients, comparing cramp and spasticity scores over a 3-month baseline versus nine months on treatment. Cramp and spasticity scores were stable over a 3-month baseline. Shortly after starting levetiracetam, there was a significant reduction in cramp severity and frequency, which persisted for the duration of this year-long study. There was also a reduction in phasic but not tonic spasticity. Levetiracetam was well tolerated. Our results justify a placebo-controlled study of levetiracetam for treatment of cramps and spasticity in patients with motor neuron diseases, and suggest that this can be accomplished with a small number of subjects followed for a short time.
authors.affiliation: Duke University Medical Center, Durham, North Carolina 27702, USA. Bedla001@mc.duke.edu
authors.forename: Richard S
authors.initials: RS
authors.lastname: Bedlack
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Pastula
authors.forename: Jodi
authors.initials: J
authors.lastname: Hawes
authors.forename: Debra
authors.initials: D
authors.lastname: Heydt
mesh_terms: D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000627:therapeutic use*; D018450:Disease Progression; D006801:Humans; D000077287:Levetiracetam; D008875:Middle Aged; D016472:Motor Neuron Disease / Q000188:drug therapy / Q000503:physiopathology; D009120:Muscle Cramp / Q000188:drug therapy* / Q000503:physiopathology; D009128:Muscle Spasticity / Q000188:drug therapy* / Q000503:physiopathology; D010865:Pilot Projects; D010889:Piracetam / Q000031:analogs & derivatives* / Q000627:therapeutic use; D010919:Placebos; D016032:Randomized Controlled Trials as Topic
chemical_list: D000927:Anticonvulsants; D010919:Placebos; D000077287:Levetiracetam; D010889:Piracetam