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Levetiracetam for phasic spasticity in multiple sclerosis.

Kathleen Hawker1, Elliot Frohman, Michael Racke

  • 1University of Texas Southwestern Medical Center at Dallas, TX 75390-9036, USA.

Archives of Neurology
|December 17, 2003
PubMed
Summary

Levetiracetam shows promise for treating multiple sclerosis (MS) spasticity. This study found it effectively reduced phasic spasticity in 12 patients with MS, though tonic spasticity remained unchanged.

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Area of Science:

  • Neurology
  • Pharmacology

Background:

  • Spasticity is a frequent and disabling symptom in multiple sclerosis (MS).
  • Existing treatments for MS spasticity can be poorly tolerated by patients.

Purpose of the Study:

  • To evaluate the efficacy of levetiracetam, an antiepileptic drug, for treating spasticity in MS patients.
  • To assess levetiracetam's potential as a well-tolerated treatment option for MS-related spasticity.

Main Methods:

  • Retrospective review of medical records for 12 patients with MS treated with levetiracetam for spasticity.
  • Outcome measures included changes in Penn Spasm Score (phasic spasticity) and Modified Ashworth Scale (tonic spasticity), both rated 0-4.
  • Patient demographics: mean age 41.0 years, predominantly female (10/11).

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Main Results:

  • Levetiracetam significantly reduced the Penn Spasm Score, indicating improvement in phasic spasticity (mean score decreased from 2.7 to 0.9).
  • No significant change was observed in the Modified Ashworth Scale, suggesting no effect on tonic spasticity.
  • Adverse events were reported by 5 patients, with one discontinuing due to edema; 3 patients noted incidental improvement in neuropathic pain.

Conclusions:

  • Levetiracetam effectively reduced phasic spasticity in MS patients but did not impact tonic spasticity.
  • The drug was generally well-tolerated, suggesting potential for treating phasic spasticity.
  • Further large-scale, controlled trials are necessary to validate these preliminary findings.