jneuroJournal of Neurology and NeuropsychiatrycoVolume 3 Issue 1 (Jan-June)MultidisciplinaryEnglish6 Months NNY20260529NeurologyLevetiracetam-Induced Urinary and Fecal Incontinence in a Post-Stroke Adult: A Case ReportEnglishY2325Zahra’a FAl-SunniEnglishNYahyaSharahelyEnglishYSarah AdnanAlmuslemEnglishYLevetiracetam (LEV) is a widely used second-generation antiepileptic drug with a generally favorable safety profile. Autonomic adverse effects, including urinary and fecal incontinence, are rarely reported, especially in younger adults. We report the case of a 47-year-old man with newly diagnosed hypertension who presented with an acute ischemic stroke and subsequently developed focal seizures treated with levetiracetam. Three months after discharge, he experienced daily urinary and fecal incontinence without concurrent seizures, cognitive impairment, metabolic disturbances, or new neurological deficits. Electroencephalography revealed no epileptiform activity. Given the temporal association with LEV initiation and the absence of alternative explanations, LEV-induced autonomic dysfunction was suspected. Discontinuation of LEV and initiation of valproic acid led to complete resolution of symptoms. This case underscores a rare but reversible autonomic adverse effect of levetiracetam and highlights the importance of clinical vigilance, particularly in patients with underlying cerebrovascular disease.Englishhttps://jneuro.clsconf.com/admin/abstract?id=42References1619Lyseng-Williamson KA. Levetiracetam: A review of its use in epilepsy. Drugs. 2011;71:489and;ndash;514.Lynch BA, Lambeng N, Nocka K, et al. The synaptic vesicle protein SV2A is the binding site for levetiracetam. Nature Neuroscience. 2004;7:553and;ndash;559.Alsallum MS, Al Anazi MS, Altwijri SH, et al. Urinary incontinence related to levetiracetam use. Cureus. 2021;13:e14407.Patel A, Delos Santos M. Levetiracetam-induced urinary incontinence. JOJ Urology and;amp; Nephrology. 2017;4.Bartholome O, Van den Ackerveken P, Sanchez Gil J, et al. SV2 family members. Frontiers in Molecular Neuroscience. 2017;10:148.de Groat WC, Griffiths D, Yoshimura N. Neural control of the lower urinary tract. Comprehensive Physiology. 2015;5:327and;ndash;396.Yokoyama K, Kuriyama M, Koike Y, et al. Suppressive effect of levetiracetam on human long-loop reflex. Clinical Neurophysiology. 2015;126:579and;ndash;585.Shorvon S, Perucca E, et al. Clinical efficacy of levetiracetam. Neurology. 2000;54:743and;ndash;748.Ogunsakin O, Tumenta T, et al. Levetiracetam-induced behavioral abnormalities. Case Reports in Psychiatry. 2020.Bertoglio D, Verhaeghe J, et al. SV2A in central nervous system disease. Journal of Nuclear Medicine. 2022;63:942and;ndash;947.Incecik F, Herguner O, et al. Urinary and fecal incontinence during levetiracetam therapy. Annals of Indian Academy of Neurology. 2015;18:479and;ndash;480.Gil-Nagel A, Gapany S, et al. Incontinence during gabapentin treatment. Neurology. 1997;48:1467and;ndash;1468.