Levetiracetam monotherapy for liver transplant patients with seizures

David R. Chabolla, Denise Harnois, James F Meschia

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

Selecting an appropriate anticonvulsant for treatment of recipients of orthostatic liver transplants who have new-onset epileptic seizures can be challenging because first-line agents may contribute to worsening encephalopathy, alter the plasma concentration of immunosuppressive agents, and result in hepatotoxicity. We describe the case of a 55-year-old man who underwent orthotopic liver transplantation because of end-stage liver disease due to alcoholic cirrhosis and hepatitis C. He required two repeat transplantation procedures. After the last procedure, epileptic seizures developed, which were initially managed with phenytoin. However, the patient remained stuporous and mental status fluctuated. Breakthrough seizures later developed in the setting of rejection. Levetiracetam (500 mg orally, twice a day) was chosen for its favorable pharmacokinetic properties as an alternative to phenytoin. By the third day of levetiracetam therapy, the patient became more responsive. At most recent follow-up, 3 months after the start of levetiracetam therapy, the patient was still treated with levetiracetam monotherapy, and seizure control was judged to be excellent.

Original languageEnglish (US)
Pages (from-to)1480-1481
Number of pages2
JournalTransplantation Proceedings
Volume35
Issue number4
DOIs
StatePublished - Jun 2003

Fingerprint

etiracetam
Seizures
Transplants
Liver
Phenytoin
Epilepsy
Alcoholic Hepatitis
Alcoholic Liver Cirrhosis
End Stage Liver Disease
Brain Diseases
Immunosuppressive Agents
Hepatitis C
Liver Transplantation
Anticonvulsants
Therapeutics
Pharmacokinetics
Transplantation

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

Levetiracetam monotherapy for liver transplant patients with seizures. / Chabolla, David R.; Harnois, Denise; Meschia, James F.

In: Transplantation Proceedings, Vol. 35, No. 4, 06.2003, p. 1480-1481.

Research output: Contribution to journalArticle

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