Long-term accidental overdose of levetiracetam in an infant

Area of Science:

• Pediatric Neurology
• Pharmacology
• Epileptology

Background:

• Levetiracetam is a newer anticonvulsant medication known for its broad efficacy and favorable safety profile.
• Ohtahara syndrome is a severe form of early-infantile epileptic encephalopathy.
• Multidrug refractory epilepsy presents significant treatment challenges in pediatric populations.

Observation:

• A case report of an infant diagnosed with Ohtahara syndrome and multidrug refractory epilepsy.
• The infant was accidentally administered a high dosage of levetiracetam (300 mg/kg/d) for a prolonged period of 35 days.
• Maternal administration error led to the accidental overdose scenario.

Findings:

• The infant tolerated the high dose of levetiracetam (300 mg/kg/d) for 35 days without any observable adverse effects.
• This represents the highest reported long-term dose of levetiracetam in an infant in existing literature.
• No neurotoxicity or other significant side effects were documented during the treatment period.

Implications:

• This case suggests a potentially wider safety margin for levetiracetam in infants than previously understood.
• The findings support further investigation into the safety and tolerability of high-dose levetiracetam regimens in pediatric epilepsy.
• This case contributes valuable data to the understanding of levetiracetam pharmacodynamics and safety in extremely young patients.