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Antiseizure Drugs and Movement Disorders

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A Correction to this article was published on 17 August 2022

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Abstract

The relationship between antiseizure drugs and movement disorders is complex and not adequately reviewed so far. Antiseizure drugs as a treatment for tremor and other entities such as myoclonus and restless leg syndrome is the most common scenario, although the scientific evidence supporting their use is variable. However, antiseizure drugs also represent a potential cause of iatrogenic movement disorders, with parkinsonism and tremor the most common disorders. Many other antiseizure drug-induced movement disorders are possible and not always correctly identified. This review was conducted by searching for all the possible combinations between 15 movement disorders (excluding ataxia) and 24 antiseizure drugs. The main objective was to describe the movement disorders treated and worsened or induced by antiseizure drugs. We also summarized the proposed mechanisms and risk factors involved in the complex interaction between antiseizure drugs and movement disorders. Antiseizure drugs mainly used to treat movement disorders are clonazepam, gabapentin, lacosamide, levetiracetam, oxcarbazepine, perampanel, phenobarbital, pregabalin, primidone, topiramate, and zonisamide. Antiseizure drugs that worsen or induce movement disorders are cenobamate, ethosuximide, felbamate, lamotrigine, phenytoin, tiagabine, and vigabatrin. Antiseizure drugs with a variable effect on movement disorders are carbamazepine and valproate while no effect on movement disorders has been reported for brivaracetam, eslicarbazepine, lacosamide, and stiripentol. Although little information is available on the adverse effects or benefits on movement disorders of newer antiseizure drugs (such as brivaracetam, cenobamate, eslicarbazepine, lacosamide, and rufinamide), the evidence collected in this review should guide the choice of antiseizure drugs in patients with concomitant epilepsy and movement disorders. Finally, these notions can lead to a better understanding of the mechanisms involved in the pathophysiology and treatments of movement disorders.

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  1. Edmond J. Safra Program in Parkinson’s Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University Health Network, Division of Neurology, University of Toronto, 399 Bathurst St, Toronto, ON, M5T 2S8, Canada

    Michel Sáenz-Farret & Alfonso Fasano

  2. Department of Neurology, University of Groningen, Groningen, The Netherlands

    Marina A. J. Tijssen

  3. Expertise Center Movement Disorders Groningen, University Medical Center Groningen, Groningen, The Netherlands

    Marina A. J. Tijssen

  4. UCLA Seizure Disorder Center, Department of Neurology, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA

    Dawn Eliashiv

  5. Departments of Neurology and Neurological Sciences and Neurosurgery, Stanford University, Stanford, CA, USA

    Robert S. Fisher

  6. Medical College of Georgia, Augusta University, Augusta, GA, USA

    Kapil Sethi

  7. Krembil Brain Institute, Toronto, ON, Canada

    Alfonso Fasano

  8. Center for Advancing Neurotechnological Innovation to Application (CRANIA), Toronto, ON, Canada

    Alfonso Fasano

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Dawn Eliashiv serves on an advisory/speaker bureau of Greenwich, Eisai, Sunovion, UCB, and Livanova. Michel Sáenz-Farret, Marina Tijssen, Robert S. Fisher, Kapil Sethi, and Alfonso Fasano have no conflicts of interest that are directly relevant to the content of this article.

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1. Research project: A. Conception, B. Organization, C. Execution; 2. Statistical analysis: A. Design, B. Execution, C. Review and critique; 3. Manuscript preparation: A. Writing of the first draft, B. Review and critique. MS-F: 1B, 1C, 3A; MAJT: 3C; DE: 3C; RSF: 3C; KS: 3C; AF: 1A, 1B, 3C. AF had the idea for this article. MS-F and AF performed the literature search and data analysis. MAJT, DE, RSF, KS, and AF critically revised the work. All the authors have read and approve the final submitted manuscript, and agree to be accountable for the work.

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Sáenz-Farret, M., Tijssen, M.A.J., Eliashiv, D. et al. Antiseizure Drugs and Movement Disorders. CNS Drugs 36, 859–876 (2022). https://doi.org/10.1007/s40263-022-00937-x

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