Longitudinal assessment of vestibular evoked myogenic potentials during one year of levetiracetam monotherapy in generalized epilepsy
İlknur Güçlü Altun1
, Rahşan İnan2, Güray Koç3, Banu Özen Barut4
1Department of Neurology, Çanakkale Onsekiz Mart University, Çanakkale, Türkiye
2Department of Neurology, Memorial Göztepe Hastanesi, İstanbul, Türkiye
3Department of Neurology, Ankara Şehir Hastanesi, Ankara, Türkiye
4Department of Neurology, University of Health Sciences, Kartal Dr. Lütfi Kırdar City Hospital, İstanbul, Türkiye
Keywords: Epilepsy, levetiracetam, vestibular evoked myogenic potentials.
Abstract
Objectives: This study aimed to evaluate the effects of one-year levetiracetam monotherapy on vestibular system function in patients with newly diagnosed generalized epilepsy using objective neurophysiological tests.
Patients and methods: In this prospective study, 12 patients (7 males, 5 females; mean age: 26.91 ± 11.36 years; range, 18 to 65 years) with generalized epilepsy who initiated levetiracetam treatment and 19 healthy controls (1 males, 18 females; mean age: 39.14 ± 11.88 years; range, 20 to 65 years) were included between March 2021 and March 2022. Cervical and ocular vestibular evoked myogenic potential (VEMP) tests were performed at baseline and after one year of treatment. Latencies, amplitudes, interpeak intervals, and asymmetry ratios were recorded. Intra- and intergroup comparisons were analyzed.
Results: After one year of levetiracetam treatment, significant reductions were observed in right cervical VEMP P13 and N23 peak amplitudes (p = 0.01; p = 0.001) and in right cervical VEMP interpeak latency (p = 0.03). In ocular VEMP measurements, right P1 latency and right N1-P1 amplitude showed significant decreases following treatment (p = 0.02). No significant pretreatment amplitude differences were observed between patients and controls.
Conclusion: One-year levetiracetam monotherapy was associated with measurable changes in selected VEMP parameters, suggesting mild effects on vestibular reflex pathways. Although these alterations were objectively detectable, their clinical impact appeared limited. Larger prospective studies are needed to clarify the long-term vestibular effects of levetiracetam.
Cite this article as: Güçlü Altun İ, İnan R, Koç G, Özen Barut B. Longitudinal assessment of vestibular evoked myogenic potentials during one year of levetiracetam monotherapy in generalized epilepsy. Turk J Neurol 2026;32(2):165-172. https://doi.org/10.55697/tnd.2026.602.
The data that support the findings of this study are available from the corresponding author upon reasonable request.
G.K., İ.G.A.: Idea/concept, analysis and/or interpretation; İ.G.A.: Design, literature review, writing the article, materials, references and fundings; B.Ö.B., İ.G.A.: Control/supervision, critical review; R.İ., İ.G.A.: Data collection and/or processing.
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.
The authors received no financial support for the research and/or authorship of this article.
The authors declare that artificial intelligence (AI) tools were not used, or were used solely for language editing, and had no role in data analysis, interpretation, or the formulation of conclusions. All scientific content, data interpretation, and conclusions are the sole responsibility of the authors. The authors further confirm that AI tools were not used to generate, fabricate, or ‘hallucinate’ references, and that all references have been carefully verified for accuracy.