Arch Neurol. 2003 Dec;60(12):1772-4
Hawker K, Frohman E, Racke M.
University of Texas Southwestern Medical Center at Dallas, TX 75390-9036,
USA.
BACKGROUND:
Spasticity is a common and debilitating symptom of multiple sclerosis (MS).
Current treatments are effective, but may be difficult to tolerate for many patients.
OBJECTIVE:
To determine if levetiracetam, a second-generation antiepileptic drug, may be useful for the treatment of spasticity in MS.
METHODS:
A retrospective medical record review of patients attending the Multiple Sclerosis Program at the University of Texas, Southwestern Medical Center at Dallas was performed.
A series of 12 patients who had been treated with levetiracetam for spasticity was identified.
Most of the patients were female (10/11), and the mean age was 41.0 years.
The main outcome measure was a change in Penn spasm score or modified Ashworth score.
Both scores are measured on a scale of 0 to 4.
RESULTS:
The Penn Spasm score (a measure of phasic spasticity) was decreased for all patients following treatment with levetiracetam.
The mean +/- SD Penn Spasm score was 2.7 +/- 0.65 at baseline and decreased to 0.9 +/- 0.29 at follow-up.
There was no change in modified Ashworth scores (a measure of tonic spasticity).
Five patients reported adverse events; 1 patient discontinued treatment owing to an adverse event (edema).
Three patients incidentally reported improvements in neuropathic pain.
CONCLUSIONS:
Levetiracetam was effective for reducing phasic spasticity but not tonic spasticity in this 12-patient case series.
The drug was well tolerated and therefore shows promise as a treatment for phasic spasticity.
Large, well-controlled trials are needed to confirm these findings.