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J Palliat Med. 2019 Oct 11. doi: 10.1089/jpm.2019.0347. [Epub ahead of print]

Levetiracetam at the End of Life: A Case Report and Discussion.

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Department of Palliative Care, Cancer and Palliative Care Network, Royal North Shore Hospital, Reserve Road St Leonards, Sydney, New South Wales, Australia.
University of Sydney Northern Clinical School, Sydney, New South Wales, Australia.
Improving Palliative Care through Clinical Trials and Research Group (ImPaCCT), University of Technology, Sydney, New South Wales, Australia.


Patients with primary brain tumors may present with neuropsychiatric symptoms such as behavioral and personality changes at any point during the disease course. Symptoms may be due to tumor treatment, the disease itself, or due to therapy for symptoms such as seizures. Levetiracetam is an attractive choice of antiepileptic medication because of relatively fewer drug interactions and may be administered through the subcutaneous route. Aggressive behavior in advanced brain tumors can have a profound negative impact on patients and their families and carers, particularly when deteriorating toward death. We report a case of neuropsychiatric symptoms in progressive glioblastoma multiforme while on stable levetiracetam doses, which improved with reduction and cessation of the drug. We review the existing literature on seizures in primary brain tumors, their antiepileptic drug management, and the risk of consequent neuropsychiatric adverse events.


epilepsy; levetiracetam; neuropsychiatric; primary brain tumor; seizure


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