Author:

Keywords:

Science & Technology, Life Sciences & Biomedicine, Clinical Neurology, Neurosciences, Neurosciences & Neurology, intention tremor, levetiracetam, Multiple sclerosis, symptomatic treatment, INTENTION TREMOR, CEREBELLAR TREMOR, CONTROLLED TRIAL, BRAIN-STEM, FOLLOW-UP, TOLERABILITY, ONDANSETRON, PERFORMANCE, ANTAGONIST, SYMPTOMS, Administration, Oral, Adult, Anticonvulsants, Cross-Over Studies, Dose-Response Relationship, Drug, Double-Blind Method, Female, Humans, Levetiracetam, Male, Middle Aged, Multiple Sclerosis, Chronic Progressive, Multiple Sclerosis, Relapsing-Remitting, Piracetam, Placebos, Severity of Illness Index, Treatment Outcome, Tremor, 1103 Clinical Sciences, 1109 Neurosciences, Neurology & Neurosurgery, 3202 Clinical sciences, 3209 Neurosciences, 5202 Biological psychology

Abstract:

BACKGROUND: Multiple sclerosis (MS) intention tremor is a disabling symptom, which is difficult to treat. OBJECTIVES: To investigate the effects of levetiracetam, an antiepileptic drug, on tremor severity and related functionality in MS. METHODS: A randomized, double-blind, placebo-controlled, cross-over study examined the effects of 6 weeks of oral levetiracetam administration (starting dose=250 mg/day, maximal dose=2000 mg/day) in 18 MS patients with disabling intention tremor. Primary outcome was Fahn's Tremor Rating Scale (FTRS) A&B. Secondary outcome measures were the nine-hole peg test, patient's opinion rated with the visual analog scale, FTRS C, and an activities of daily life questionnaire and validated tremor indexes derived during the performance of a digitized spiral drawing task and a wrist step-tracking task. Repeated measures analysis of variance and Friedman tests were applied. RESULTS: In all, 14 patients completed the trial. Maximal dose intake ranged from 1000 to most commonly 2000 mg, depending on patients' tolerance level. No significant effects of levetiracetam were found for any outcome measure. Further analyses on subgroups with different tremor severity showed no differential effects. Eight patients reported adverse events such as fatigue and stomach ache. CONCLUSIONS: Levetiracetam intake of 2000 mg/day did not affect tremor severity or functionality in patients with MS.