Visual and Auditory Hallucinations: An Uncommon Side Effect of Levetiracetam in an Elderly Patient

This report focuses on a 77-year-old female who was admitted to an acute geriatrics unit at a tertiary care hospital with a history of recurrent falls and right leg weakness. Computed tomography of the head demonstrated acute left subdural hemorrhage with a possible extradural component at the vertex. This was causing mass effect with effacement of the left superior, frontal, and parietal lobes with no hydrocephalus or fracture. She had an episode of non-convulsive seizure secondary to a head injury and was commenced on levetiracetam. The patient started to display previously unreported visual and auditory hallucinations within four days of starting the medication. After ruling out other potential causes of the symptoms, our team narrowed it down to levetiracetam-induced hallucinations and subsequently discontinued the medication. We commenced pregabalin for seizure control, and there were no further episodes of hallucinations.