Rivaroxaban Plasma Levels and Levetiracetam
Authors: Vineet Punia
Journal: Annals of Internal Medicine (2020)

Letters3 November 2020Rivaroxaban Plasma Levels and LevetiracetamVineet Punia, MD, MSVineet Punia, MD, MSEpilepsy Center, Cleveland Clinic, Cleveland, Ohio (V.P.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L20-1065 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Paciullo and colleagues' case report (1) describing levetiracetam use reducing rivaroxaban levels is highly clinically relevant. This is especially true because levetiracetam is one of the most commonly prescribed antiseizure medications, specifically in critical care settings (2). The authors describe an elderly man with late-onset epilepsy who presents with “absence seizures starting in his right frontal lobe.” The nomenclature used to describe the clinical semiology (that is, absence seizure) and the origin of the seizure (that is, the right frontal lobe, which was probably determined using electroencephalography) are fundamentally incompatible.Absence seizures are the prototype of generalized-onset ...References1. Paciullo F, Costa C, Gresele P. Rivaroxaban plasma levels and levetiracetam: a case report [Letter]. Ann Intern Med. 2020;173:71-2 LinkGoogle Scholar2. Alvarez V, Rodriguez Ruiz AA, LaRoche S, et al. Critical Care EEG Monitoring Research Consortium (CCEMRC). The use and yield of continuous EEG in critically ill patients: a comparative study of three centers. Clin Neurophysiol. 2017;128:570-8. [PMID: 28231475] CrossrefMedlineGoogle Scholar3. Guerrini R, Marini C, Barba C. Generalized epilepsies. Handb Clin Neurol. 2019;161:3-15. [PMID: 31307608] CrossrefMedlineGoogle Scholar4. Sen A, Jette N, Husain M, et al. Epilepsy in older people. Lancet. 2020;395:735-48. [PMID: 32113502] CrossrefMedlineGoogle Scholar5. Fisher RS, Cross JH, French JA, et al. Operational classification of seizure types by the International League Against Epilepsy: position paper of the ILAE Commission for Classification and Terminology. Epilepsia. 2017;58:522-30. [PMID: 28276060] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Epilepsy Center, Cleveland Clinic, Cleveland, Ohio (V.P.)Disclosures: The author has disclosed no conflicts of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L20-1065. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoRivaroxaban Plasma Levels and Levetiracetam: A Case Report Francesco Paciullo , Cinzia Costa , and Paolo Gresele Rivaroxaban Plasma Levels and Levetiracetam Francesco Paciullo , Cinzia Costa , and Paolo Gresele Rivaroxaban Plasma Levels and Levetiracetam Marc A. Brouwer , Stijn P.G. van Vugt , Jeroen Jaspers Focks , Sander A.J. Damen , and Freek W.A. Verheugt Rivaroxaban Plasma Levels and Levetiracetam Maja Hellfritzsch , Jakob Christensen , and Lars Peter Nielsen Metrics 3 November 2020Volume 173, Issue 9Page: 771-772KeywordsBlood plasmaConflicts of interestCritical careDisclosureElderlyElectroencephalographyEpilepsyEpileptic seizuresFrontal lobePatient advocacy ePublished: 3 November 2020 Issue Published: 3 November 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...