Seizure Deterioration with Increased Levetiracetam Blood Concentration during the Postpartum Period in Refractory Temporal Lobe Epilepsy |
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| Authors: | Mai Kikumoto Shuichiro Neshige Takeo Shishido Hiroki Ueno Shiro Aoki Koji Iida Hirofumi Maruyama |
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| Affiliation: | 1.Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan; 2.Epilepsy Center, Hiroshima University Hospital, Japan; 3.Department of Neurology, Hiroshima City Asa Citizens Hospital, Japan; 4.Department of Neurology, Hiroshima City Hiroshima Citizens Hospital, Japan; 5.Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan |
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| Abstract: | ![]()
We evaluated a 39-year-old pregnant woman with right temporal lobe epilepsy. During the second trimester, seizure deterioration was responsive to an increased daily dose of levetiracetam (LEV). However, immediately after delivery, new non-habitual seizures emerged along with a sharply increased LEV concentration. The frequency of habitual seizures also slightly increased. The non-habitual seizures completely disappeared, and the frequency of the habitual seizures improved to the baseline level after the LEV dosage was reduced. Thus, a paradoxical effect of an increased LEV blood concentration was assumed to be a potential cause of these events. Peripartum pharmacokinetic fluctuations in LEV levels should be monitored carefully. |
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| Keywords: | focal impaired awareness seizure levetiracetam pregnancy |
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