Abstracts

This retrospective review was undertaken after Hawker, et al published treatment benefits from Levetiracetam for phasic spasticity in multiple sclerosis, and because spastic cerebral palsy patients frequently also have coexisting epilepsy. Currently no anticonvulsant is known also to treat spasticity in cerebral palsy. Due to the broad spectrum of action of Levetiracetam for epilepsy it is a potentially good medication for seizures associated with cerebral palsy. A retrospective review of cerebral palsy patients with epilepsy covering a period of four years from January 2000 until December 2003 was undertaken. In the child neurology clinic a total of 120 patients with cerebral palsy were identified from this time period. From this group, two patients with epilepsy were identified who were treated with Levetiracetam for seizures. On Levetiracetam both patients identified in this review showed improvement in seizure frequency and also decreased spasticity. At the time of treatment no other medication was introduced that would affect a change in tone in these two cerebral palsy patients. Levetiracetam appears to have unexpectedly improved spasticity in these two patients as well as decrease their seizure frequency. This is the first report suggesting Levetiracetam, an anticonvulsant, is beneficial in at least some patients for spasticity associated with cerebral palsy. Currently cerebral palsy patients with seizures are treated with an anticonvulsant for seizures and a muscle relaxant for spasticity or another antispasticity treatment . Monotherapy with Levetiracetam would be a superior treatment approach for epilepsy in cerebral palsy when compared to the current standard approach of using an anticonvulsant and a muscle relaxant. Baclofen, a commonly used muscle relaxant for cerebral palsy, may unfortunately activate seizure activity or increase seizure frequency. Although the numbers are small in this study, they are suggestive of a treatment benefit from Levetiracetam for spastic cerebral palsy and are consistent with the previous findings of Hawker, et al showing a benefit from Levetiracetam for spasticity in multiple sclerosis.