İlknur GÜÇLÜ ALTUN, Rahşan İNAN, Güray KOÇ, Banu ÖZEN BARUT
Turkish Journal of Neurology - 2026;32(2):165-172
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.
