Related Experiment Video

Updated: Sep 5, 2025

Acquisition of Resting-State Functional Magnetic Resonance Imaging Data in the Rat
12:41

Acquisition of Resting-State Functional Magnetic Resonance Imaging Data in the Rat

Published on: August 28, 2021

4.4K

High-Dose Dexmedetomidine for Severe Hyperactive Delirium Secondary to Intravenous Levetiracetam on Two Separate

Chad Ward1, Kiran Khalid2, Nicole Rozette3

  • 1Department of Pediatric Intensive Care Medicine, Carilion Children's Hospital, Virginia Tech Carilion School of Medicine, Roanoke, VA, USA.

Case Reports in Psychiatry
|July 12, 2022
PubMed

Insights

Severe delirium and aggression in a child treated with IV levetiracetam resolved with dexmedetomidine. This case highlights a potential adverse effect of levetiracetam and the efficacy of dexmedetomidine for managing such behavioral emergencies.

Area of Science:

  • Pediatric Neurology
  • Neuropharmacology
  • Critical Care Medicine

Background:

  • Status epilepticus requires prompt and effective treatment.
  • Intravenous levetiracetam is a common first-line agent for status epilepticus.
  • Adverse neuropsychiatric effects of antiepileptic drugs can complicate treatment.

Observation:

  • A 5-year-old male experienced severe hyperactive delirium with violent behavior after IV levetiracetam administration on two separate occasions.
  • Symptoms included aggression towards family and healthcare staff.
  • Standard workup, including neuroimaging and CSF analysis, was unremarkable.

Findings:

  • Risperidone was ineffective in managing the levetiracetam-induced delirium.
  • A continuous infusion of high-dose IV dexmedetomidine rapidly and significantly improved the patient's violent behavior and delirium.
  • Dexmedetomidine provided crucial symptom control to prevent harm.

Implications:

  • Levetiracetam may be associated with severe hyperactive delirium and aggression in some pediatric patients.
  • Continuous IV dexmedetomidine is a potential therapeutic option for managing drug-induced delirium and agitation in children.
  • This case underscores the importance of recognizing and managing neuropsychiatric adverse effects of antiepileptic drugs.

More Related Videos

Microdialysis of Excitatory Amino Acids During EEG Recordings in Freely Moving Rats08:47

Microdialysis of Excitatory Amino Acids During EEG Recordings in Freely Moving Rats

Published on: November 8, 2018

11.5K
Non-restraining EEG Radiotelemetry: Epidural and Deep Intracerebral Stereotaxic EEG Electrode Placement06:58

Non-restraining EEG Radiotelemetry: Epidural and Deep Intracerebral Stereotaxic EEG Electrode Placement

Published on: June 25, 2016

19.3K

Related Concept Videos

Antiepileptic Drugs: Modulators of Neurotransmitter Release Mediated by SV2A Protein01:20

Antiepileptic Drugs: Modulators of Neurotransmitter Release Mediated by SV2A Protein

Antiepileptic drugs, such as levetiracetam (Keppra) and brivaracetam (Briviact), have emerged as crucial tools in managing epilepsy. These medications exert their therapeutic effects by targeting the synaptic vesicle protein SV2A, a transmembrane glycoprotein primarily found in the brain.
SV2A is a transmembrane glycoprotein located predominantly in the brain, modulating the release of neurotransmitters for neuronal communication. Both levetiracetam and brivaracetam exhibit a high affinity for...
431
Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
192
Skeletal Muscle Relaxants: Adverse Effects01:21

Skeletal Muscle Relaxants: Adverse Effects

Skeletal muscle relaxants are widely used for muscle paralysis and relieving pain following any muscle injury or stiffness. However, depending on the drug type, they can have adverse effects that range from mild to severe. Usually, nondepolarizing neuromuscular blockers have minimal side effects. For example, drugs like d-tubocurarine, cisatracurium, and rocuronium cause hypotension, whereas drugs like baclofen, when stopped abruptly, can lead to the recurrence of spastic conditions.
Unlike...
462
Sedatives and Hypnotics Drugs: Miscellaneous Agents01:17

Sedatives and Hypnotics Drugs: Miscellaneous Agents

Sedatives and hypnotics encompass a wide range of substances, each with its unique mechanism of action, uses, and potential adverse effects.
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
232
Sedatives and Hypnotics Drugs: Barbiturates01:20

Sedatives and Hypnotics Drugs: Barbiturates

Sedatives and hypnotics encompass a drug class that acts on the central nervous system (CNS) to alleviate anxiety, promote relaxation and induce sleep.These drugs function by amplifying the actions of the neurotransmitter γ-aminobutyric acid (GABA), resulting in reduced neuronal activity. Barbiturates, a subset of sedatives and hypnotics first synthesized in the late 1800s, are categorized into ultra-short, short, intermediate, and long-acting groups based on their duration of effect. A...
457
Antiepileptic Drugs: Potassium Channel Activators01:20

Antiepileptic Drugs: Potassium Channel Activators

Ezocgabine or retigabine, an antiepileptic drug of remarkable efficacy, has revolutionized the management of seizures. It is a potassium channel activator, explicitly targeting the family of Q subtype potassium channels. It enhances the transmembrane potassium currents, regulating neuronal excitability. This action stabilizes the resting membrane potential, a pivotal factor in mitigating the hyperexcitability that characterizes epilepsy.
Ezogabine has gained approval as an adjunctive treatment...
270