Emesis responsive to levetiracetam

• Published in: Journal of neurology, neurosurgery and psychiatry Vol. 79; no. 7; pp. 847 - 849
• Main Authors: Lee, J W, Bromfield, E, Kesari, S
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd 01.07.2008; BMJ Publishing Group LTD
• Subjects: Aged; Anticonvulsants - therapeutic use; Binding sites; Brain Neoplasms - pathology; Brain Neoplasms - therapy; Female; Humans; Nausea; Papilloma, Choroid Plexus - pathology; Papilloma, Choroid Plexus - therapy; Piracetam - analogs & derivatives; Piracetam - therapeutic use; Rodents; Vomiting; Vomiting - drug therapy; Vomiting - etiology
• ISSN: 0022-3050; 1468-330X
• DOI: 10.1136/jnnp.2007.142117

DISCUSSION The physiological manifestations of emesis involve a complex interaction between the neuronal circuitry of the medulla, baroreceptor reflexes, respiration control and gastric tone and motility. 2 In particular, the dorsal vagal complex and the neurons surrounding the area postrema, located near the obex at the caudal tip of the fourth ventricle, have been implicated as a central trigger zone for emesis, although neurons efferent to the muscles involved in emesis are likely distributed throughout the medulla. Because of the episodic nature of the vomiting as well as the dramatic response to levetiracetam, emesis as a seizure manifestation was considered in this patient, despite the subtentorial location of the lesion.