A Girl with Idiopathic Epilepsy Showing Forced Normalization after Levetiracetam Administration.

Abstract

BACKGROUND:

Forced normalization has been reported in association with almost all anti-epileptic drugs.

PATIENT:

We report on a 9-year-old girl with idiopathic epilepsy who showed forced normalization after administration of levetiracetam (LEV). She initially presented with generalized tonic-clonic seizures when she was 4 years old. Diffuse sharp and slow wave complexes (SWCs) were observed on electroencephalography (EEG). We prescribed sodium valproate (VPA) and benzodiazepines, but the seizures and EEG findings worsened gradually. Although subsequent administration of LEV stopped the seizures, the patient became subject to episodes of rage and violent behavior. Forced normalization was confirmed by the disappearance of SWCs on EEG. We reduced the dose of LEV and tried in various ways to resolve the situation, but finally we had to abandon LEV.

CONCLUSIONS:

To the best of our knowledge, this is the first report of a patient with idiopathic epilepsy but without disabilities in everyday life showing forced normalization associated with LEV administration.

• Authors: Yasuhiko Kawakami, Tetsuya Okazaki, Masato Takase, Osamu Fujino, Yasuhiko Itoh
• Journal: Journal of Nippon Medical School = Nippon Ika Daigaku zasshi (J Nippon Med Sch) Vol. 82 Issue 5 Pg. 250-3 ( 2015) ISSN: 1347-3409 [Electronic] Japan
• PMID: 26568392 (Publication Type: Case Reports, Journal Article)

Chemical References

• Anticonvulsants
• Levetiracetam
• Piracetam

Topics

• Anticonvulsants (therapeutic use)
• Child
• Electroencephalography
• Epilepsy (drug therapy, physiopathology)
• Female
• Humans
• Levetiracetam
• Piracetam (analogs & derivatives, therapeutic use)
• Treatment Outcome