SHM Converge Scientific Abstract ePoster Gallery-Keppra Induced Rhabdomyolysis

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This case describes a 53-year-old man with no prior seizure history who was admitted after a witnessed generalized seizure. He was loaded with levetiracetam (Keppra) and briefly intubated for airway protection. Brain imaging showed no acute findings, only evidence of an old cerebrovascular accident.<br /><br />Although the patient stabilized clinically and had no recurrent seizures, his creatine kinase (CK) levels continued to rise dramatically. Because rhabdomyolysis can occur after seizures, the team evaluated other possible causes, including propofol infusion syndrome, statin use, and seizure-related muscle injury. These were considered unlikely, leading to suspicion of Keppra-induced rhabdomyolysis, a rare but important adverse effect.<br /><br />The patient’s CK levels were closely monitored, along with renal function. Notably, he did not develop kidney injury, and his McMahon score remained low at 5, suggesting a lower risk for severe rhabdomyolysis complications. Neurology recommended continued observation rather than stopping Keppra, given the need for seizure control and the patient’s stable condition. Over time, CK levels plateaued and then began to decline, and the patient improved without discontinuing levetiracetam. He was ultimately discharged with follow-up.<br /><br />The report highlights that levetiracetam is generally well tolerated, but rare cases of rhabdomyolysis may occur. Diagnosis is challenging because seizures and other medications can also elevate CK. The key clue is a temporal relationship between starting Keppra and the rise in CK. The authors emphasize the importance of careful monitoring of CK and renal function during initial therapy, and they note that clinicians should also consider interstitial nephritis if kidney dysfunction develops.

Asset Subtitle

Amith Skandhan

Meta Tag

Author List Amith Skandhan, Catherine Morris

Category Clinical Vignettes

Concept Levetiracetam

Concept Rhabdomyolysis

Concept Creatine Kinase

Concept Medication-Induced Rhabdomyolysis

Concept Temporal Association

Distinguished Non-Finalist

Presenter Organization UT Health Science Center San Antonio

Presenting Author Amith Skandhan

Track Adult

Keywords

levetiracetam

Keppra

rhabdomyolysis

creatine kinase

generalized seizure

McMahon score

intubation

renal function

adverse drug reaction

neurology

Levetiracetam

Rhabdomyolysis

Creatine Kinase

Medication-Induced Rhabdomyolysis

Temporal Association