In this retrospective case series, we present two patients with primary lateral sclerosis (PLS) and spasticity-related gait impairment. Both patients were assessed with 6-min walk tests (6MWT) and timed up and go (TUG) at baseline and after 4 weeks of oral levetiracetam. Following levetiracetam therapy, Patient 1 improved 27.3% (148.5 to 189 m) on 6MWT and 26.1% (23–17 s) on TUG. Patient 2 improved 18% (90 m in 4:29 min to 112 m in 6 min) on 6MWT and 10% (46–41 s) on TUG. Larger prospective trials of levetiracetam for spasticity and gait may be considered in PLS.
