Encephalopathy induced by levetiracetam added to valproate

Background We report on the manifestation of a levetiracetam (LEV)-induced encephalopathy. Findings A 28-year-old man suffering from idiopathic epilepsy with generalized seizures was treated with LEV (3000 mg) added to valproate (VPA) (2000 mg). Frequency of generalized tonic-clonic seizures increased from one per 6 months to two per month. Neuropsychological testing showed impaired word fluency, psychomotor speed and working memory. The interictal electroencephalogram (EEG) showed a generalized slowing to 5 per second theta rhythms with bilateral generalized high-amplitude discharges. Outcome Following discontinuation of LEV, EEG and neuropsychological findings improved and seizure frequency decreased.