Sir,Levetiracetam (LEV), an antiepileptic drug (AED), has become widely used in the treatment of several types of epilepsy. It is used as an adjunctive therapy in the treatment of partial onset, myoclonic and/or primary generalized tonic-clonic seizures. The compound binds with high affinity to the presynaptic vesicle protein 2A co-opting with synaptotagmin and, thereby, may putatively regulate synaptic transmitter release. Other mechanisms include inhibition of Zn2+-associated negative gama-aminobutyric acid (GABA) modulation, high-voltage-gated N-type Ca2+ channel currents, and GABA release.[1] There are no known interactions between LEV and any other drug. Adverse effects include somnolence, and behavioral changes are usually mild to moderate. We report urinary and fecal incontinence not related to seizures in a child treated with LEV.A 11-year-old boy presented with a history of urinary and fecal incontinence since last 10 days to our hospital. He was born of an uneventful full-term pregnancy. Developmental milestones were normal. On medical history, he had nocturnal isolated seizures, followed by a postictal motor deficit at the right arm since 1 month. The electroencephalography (EEG) showed a normal background activity with spikes in the bilateral centrotemporal area. LEV had started 10 mg/kg/day, but several brief partial seizures were continued. The dose was increased to 20 mg/kg/day (500 mg/day), and his seizures were stopped. Three weeks after starting LEV therapy, he experienced daily urinary and fecal incontinence. On his examination, the vital signs, including the blood pressure were normal. His height and weight were normal limit for his age. The physical and neurological examination were unremarkable. There was no evidence of urinary tract and gastrointestinal infection.On laboratory examination, routine hematological, biochemical analyzes, the urine and stool analysis were normal. A magnetic resonance imaging (MRI) scan of his lumbosacral spine and brain was showed as normal. In control EEG, we did not find non-convulsive status epilepticus.We thought LEV may be the cause of his complaints and stopped LEV therapy. His urinary and fecal incontinence had completely resolved after discontinuation of LEV.LEV is one of the new generation AED with an acceptable side effect profile used for preventing seizures. LEV has a different molecular structure from other new AEDs, does not bind to plasma proteins, and is eliminated by the kidneys. It has been argued that LEV can act on the N-type Ca2+ channel and can reverse the GABA and glycine-gated currents.[1] Fatigue, somnolence, behavioral problems and headache are among known side effects of LEV.In the literature, there have been few reports of urinary and fecal incontinence induced by AEDs.[234] Gil-Nagel et al.,[2] reported a 43-year-old man with mental retardation and epilepsy in whom fecal and bladder incontinence induced by gabapentin. The other case described by Iyer et al.[5] They described a 65-year-old woman with neuropathic pain. These cases illustrates that gabapentin can cause both urinary and fecal incontinence. Gil-Nagel et al.,[2] hypothesized that incontinence was thought to be related to an effect of gabapentin in the cortex, interfering with the frontal lobe inhibition of the micturition center in the pons by modulation of neurotransmitters GABA and glutamate. Sandyk reported urinary incontinence associated with clonazepam therapy in a case.[3] In another case, Anders et al.,[4] reported case of urinary incontinence due to carbamazepine treatment. We reported a 11-year-old boy with urinary and fecal incontinence during LEV therapy. To our knowledge, this is the first report of urinary and fecal incontinence induced by LEV therapy in the literature. There was no evidence of urinary and gastoinintestinal tract infection, and no evidence central nervous system involvement in our patient. Therefore, we thought the cause of his complaints due to LEV therapy. The exact urinary and fecal incontinence mechanism of LEV is unknown.In conclusion, we conclude that LEV may cause urinary and fecal incontinence, however these effects are reversible. In clinical placebo controlled trials some adverse event may not be more frequent in the study drug group, post marketing experiences can sometimes discover new effects and side effects. The fact that the incontinence improved completely after drug withdrawal supports the ascribability hypothesis. Children treated with LEV should be warned regarding these potential adverse effects, to facilitate early withdrawal of drug.