Background: Several studies have investigated the potential beneficial and side effects of levetiracetam on Parkinson's disease (PD). We hereby report a case of PD exacerbation following Levetiracetam administration for seizure prophylaxis.
Case description: A 77-year-old female, known to have PD, presented with a head injury following a fall. Brain CT showed diffuse subarachnoid hemorrhage. The patient was started on Levetiracetam for seizure prophylaxis. Four days after, the patient dropped GCS from 15 to 9. She was having progressive exacerbation of Parkinson's disease symptoms. After ruling out all possible causes of PD exacerbation, Levetiracetam was gradually weaned until it was discontinued. Consequently, the patient had rapid significant clinical improvement after discontinuation of Levetiracetam.
Conclusion: The use of Levetiracetam for seizure prophylaxis in patients with PD can rarely lead to acute exacerbation of symptoms and worst outcome. Close monitoring of patients with PD is recommended when prescribing anti-epileptics.
Keywords: Levetiracetam; Parkinson's disease; SAH; prophylactic; seizures; traumatic.
© The Author(s) 2025. Published by Oxford University Press.