[Effect of levetiracetam on intractable secondarily generalized seizure and depression]

Levetiracetam (brand name: E Keppra®) is a new antiepileptic drug marketed in Japan since 2010 1, 2). Clinical reports of its use in Japan are few. Our experience with levetiracetam in a patient with secondarily generalized seizures yielded interesting findings. The patient was a 62-year-old man receiving 4 antiepileptic drugs and 9 psychotropic drugs for treatment of secondarily generalized seizures (due to a cerebral contusion that occurred 20 years ago) and associated depressive symptoms, mainly anxiety and insomnia. He begun to wobble and, his increasing gait disturbance led to frequent falls. He recently underwent emergency surgery for acute extradural hematoma due to head contusion. Concomitant administration of levetiracetam, initiated after surgery, resulted in control of the epilepsy, resolution of the depressive symptoms, and reduction of multiple drugs doses. The patient was able to return to normal activity. Control of his epilepsy was probably attributable to the following: (1) the antiepileptic effect of levetiracetam and (2) improvement of the seizure threshold by streamlining multiple concomitant drugs. Although the effect of levetiracetam on depression is unclear, it is worth noting that control of the patient's epilepsy produced an improvement in the symptoms of depression.