Investigation of The Frequency and Risk Factors of Hyponatremia in Patients Receiving Levetiracetam Treatment

Background: Levetiracetam (LEV) is a widely used antiepileptic drug (AED) in the treatment of various type of seizures. The side effects of LEV are somnolence, asthenia, dizziness, mood changes, kidney dysfunction, rhabdomyolysis, minor infections, and thrombocytopenia. Recently, hyponatremia due to LEV therapy has been reported.
The Aim: The goal of the study was to evaluate frequency and risk factors associated with hyponatremia in LEV administration.
Method: One hundred and fiftytwo children were enrolled. The risk factors were analysed.
Results: Among the 152 patients, 79 (52.0%) were boys and 73 (48.0%) were girls, and the mean age was 90.37 ± 46.43 months (24-188 months). Of the 152 patients, 64 (42.1%) were treated monotherapy, and 88 (57.9%) polytherapy. We detected hyponatremia in one patient (0.7%). The serum sodium level was 130 mmol/l. The patient was asymptomatic, and LEV dose was 25 mg/kg. To investigate the etiology of hyponatremia in the patient, syndrome of inappropriate antidiuretic hormone secretion tests were performed and found normal. There were no significant differences in the hyponatremia between the patients treated with LEV.
Conclusion: We detected that LEV may cause hyponatremia. When treating patients with LEV, clinicians should closely monitor serum sodium level. To the best of our knowledge, this is the first study of hyponatremia associated with LEV therapy in children.

Keywords:Levetiracetam; Hyponatremia; Children

Abbreviations:AEDs: Antiepileptic Drugs; LEV: Levetiracetam; GABA: Gammaaminobutyric Acid; ILAE: International League Against Epilepsy; CT: Cerebral computed tomography; SIADH: Antidiuretic Hormone Secretion