Dyskinetic cerebral palsy (CP) is a movement disorder that is difficult to treat and which causes major disability. We report on two female patients (aged 5y and 8y) who experienced severe perinatal asphyxia and developed dyskinetic CP, clinically characterized by choreoathetosis. Neuropsychological testing of these children showed a low average developmental quotient and no attentional deficit. Monotherapy with levetiracetam was initiated to improve balance control and fine motor skills. Treatment was evaluated by use of video and the Visual Analog Scale. In both children an impressive improvement of balance control and fine motor skills was observed. No side effect occurred. Furthermore, both patients showed more interest and pleasure during activities according to their parents. In a recent multidisciplinary evaluation of the initiated therapy, the parents, the therapist, and the rehabilitation doctor all confirmed that the effect initially observed was still present at 14 and 26 months later. To our knowledge, this report on two patients with dyskinetic CP is the first suggesting that levetiracetam may offer an alternative to the standard therapy of involuntary, uncontrolled movements in this group of patients.Cerebral palsy (CP) is a non-progressive disorder of posture or movement caused by a lesion of the developing brain. The Surveillance of Cerebral Palsy in Europe (SCPE) has classified CP into three main groups (spastic, dyskinetic, and ataxic), which are based on clear neurological signs indicating pathology in the cerebral motor systems. Dyskinetic CP presents involuntary, uncontrolled, recurring, and, occasionally, stereotyped movements. SCPE uses dystonic and choreoathetotic subtypes for subgrouping dsykinetic CP.1 The pathophysiology of dyskinesia in CP is not fully elucidated, but existing evidence suggests that disorders of the basal ganglia play a role in this entity. The symptomatic treatment of this movement disorder is still very difficult. In a retrospective survey of 22 children with extrapyramidal CP, only a minority showed a functional improvement using trihexyphenidyl, which is a centrally active muscarinic antagonist. 2Several anticonvulsants seem to be efficacious for the treatment of (paroxysmal) involuntary movement disorders. On the basis of a recent report about levetiracetam efficacy in the treatment of movement disorders, we started levetiracetam in two patients with dyskinetic CP unresponsive to conventional drugs mostly used in such cases. 3To our knowledge, this report on two patients with dyskinetic CP, is the first suggesting that levetiracetam may offer an alternative to standard therapy of involuntary, uncontrolled movements in this group of patients. METHODInformed consent of the parents was obtained for both patients. Levetiracetam was only started when the other available drugs usually prescribed failed. Baclofen (GABAagonist) and artane (Muscarine-antagonist) were tried but ª