Abnormal night melatonin level in a patient with well-controlled epilepsy without sleep disturbances – could it be associated with levetiracetam therapy: A case report

Orlina Georgieva Chaneva; Zdravka Nikolaeva Vasileva

doi:10.30574/wjarr.2021.10.3.0239

Abnormal night melatonin level in a patient with well-controlled epilepsy without sleep disturbances – could it be associated with levetiracetam therapy: A case report

Orlina Georgieva Chaneva ^{1, 2, *} and Zdravka Nikolaeva Vasileva ^{1, 2}

¹ Department of Neurology, Medical University – Plovdiv, 4000 Bulgaria 66 Pestersko shosse blvd. 4000 Plovdiv, Bulgaria.

²Clinic of Neurology, UMHAT “St. George”, Plovdiv, 4000 Bulgaria 66 Pestersko shosse blvd. 4000 Plovdiv, Bulgaria.

Case Study

World Journal of Advanced Research and Reviews, 2021, 10(03), 085–087

Article DOI: 10.30574/wjarr.2021.10.3.0239

DOI url: https://doi.org/10.30574/wjarr.2021.10.3.0239

Publication history:

Received on 19 April 2021; revised on 06 June 2021; accepted on 10 June 2021

Abstract:

We present a case report of a 23-year old male with newly diagnosed epilepsy manifested with generalized tonic seizures. Levetiracetam (LEV) was started and the patient was seizure free. The patient demonstrated intermediate chronotype determined by the Morningness-Eveningness Questionnaire (MEQ). There was no epileptiform activity on electroencephalography (EEG) and polysomnography (PSG), sleep architecture disturbances (PSG) or daytime sleepiness (Epworth sleepiness score, Multiple sleep latency test) at the onset and after 3 months of LEV therapy. The melatonin serum levels after 3 months of LEV treatment were 22.00 pg/ml at 3 a.m. and 23.60 pg/ml at 8 a.m. - there was no normal night peak concentration. This abnormality may be associated with a later night peak melatonin concentration, the treatment with levetiracetam being a possible explanation. We consider the presented clinical case of special interest because of the combination of absence of normal night peak melatonin concentration, normal sleep parameters and non-extremely presented chronotype. We suggest that such patients could benefit from add-on therapy with melatonin.

Keywords:

Epilepsy; Seizures; Melatonin; Chronotype; Levetiracetam

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Abnormal night melatonin level in a patient with well-controlled epilepsy without sleep disturbances – could it be associated with levetiracetam therapy: A case report

Orlina Georgieva Chaneva 1, 2, * and Zdravka Nikolaeva Vasileva 1, 2

Orlina Georgieva Chaneva ^{1, 2, *} and Zdravka Nikolaeva Vasileva ^{1, 2}