Levetiracetam-Induced Rhabdomyolysis: An Alarming and Unexpected Turn in Seizure Management

Levetiracetam is a widely used antiepileptic drug favored for its efficacy and favorable safety profile. However, rare cases of levetiracetam-induced rhabdomyolysis have been reported, posing diagnostic and therapeutic challenges. We describe a 29-year-old male with a psychiatric history who presented with a generalized tonic-clonic seizure. The patient was started on levetiracetam for seizure management. Despite initial clinical improvement, creatine kinase levels rose dramatically, exceeding 22,000 U/L, consistent with severe rhabdomyolysis. Levetiracetam was discontinued and replaced with valproic acid, resulting in significant creatine kinase reduction and clinical recovery. This case highlights the importance of recognizing levetiracetam as a potential, albeit rare, cause of rhabdomyolysis. Early identification and prompt discontinuation of the drug, combined with supportive care, are crucial to prevent serious complications such as acute kidney injury. Clinicians should maintain vigilance when monitoring patients on levetiracetam, especially if creatine kinase levels rise unexpectedly.