Levetiracetam, a pyrolidine-derivate analogous to piracetam is a new antiepileptic drug reported to have a high degree of tolerability in both adults and children with epilepsy. It is approved in Europe for monotherapy and adjunctive treatment of partial seizures with or without secondary generalization, as well as for adjunctive therapy of myoclonic seizures and primarily generalized tonic-clonic seizures [1]. Common adverse events of levetiracetam include somnolence, agitation, asthenia, headache, abnormal behaviour, depression, mood disorder and suicidal intent. Hematologic adverse effects are extraordinary. Lafora disease is the most common and severe form of adolescent-onset progressive myoclonus epilepsies a group of devastating inherited neurodegenerative disorders characterized by progressively worsening myoclonus, epilepsy, early dementia and death [2]. We present a case of pancytopenia most likely induced by levetiracetam in a 16-years-old girl with Lafora disease.A sixteen-year-old girl was admitted to our ICU with the complaint of short of breath. She was diagnosed as Lafora disease 3 years ago. She was receiving sodium valproat therapy for her epileptic seizures. Routine laboratory results were in normal range. Levetiracetam 1000 mg  2 was added to sodium valproat therapy. On the day of admission, complete cell count (CBC) showed haemoglobulin: HGB 8.4 g/dl (normal range 12-18.1 g/dl); platelet: PLT 280.9  10 3 /ml (normal range 142-424 10 3 /ml); white blood cells (WBC) 7.2  10 3 /ml (normal range 4.3-10.3 10 3 /ml). Four days later, CBC showed pancytopenia with HGB 6.2 g/dl, PLT 7383  10 3 /ml, and WBC 2.2  10 3 /ml levels. The patient received 3 units of packed red blood cells. Pancytopenia induced by levetiracetam was suspected and the drug was withdrawn. Four days later, improvement in the CBC was observed, with hemoglobin level at 11.9 g/l, platelet count of 180  10 3 /ml, and WBCs 7.2  10 3 /ml. CBC levels remained within normal ranges over the following days. According to the Naranjo probability scale, levetiracetam-induced pancytopenia was possible [3].Serious blood dyscrasias are uncommon in patients taking antiepileptic agents [1]. Pancytopenia has been associated with use of carbamazepine, phenobarbital, phenytoin, and valproate. The mechanism for the antiepileptic effect of levetiracetam is still unknown but its favourable pharmacokinetic profile, good tolerability and rapid effects make it very popular as an antiepileptic agent. Our case represents pancytopenia associated with levetiracetam in a Lafora disease patient. Most adverse effects of levotiracetam occur during the first 4 weeks of therapy and do not appear to be dose related. Abnormal liver function test results, hepatic failure, hepatitis, weight loss, leukopenia, neutropenia, pancreatitis and pancytopenia with bone marrow suppression have been identified in patients taking levetiracetam in postmarketing surveillance studies. Two cases of levetiracetaminduced pancytopenia have been described in the literature. First cas...