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Levetiracetam in refractory pediatric epilepsy
1Department of Neurology, University of Texas-Houston, 77030, USA. James.W.Wheless@uth.tmc.edu
Insights
Levetiracetam shows promise as an add-on therapy for refractory epilepsy in children. This study found it effective in reducing seizure frequency, with some patients experiencing cognitive benefits.
Area of Science:
- Pediatric Neurology
- Clinical Pharmacology
Background:
- Levetiracetam is a newer-generation antiepilepsy drug with a favorable safety profile in adults.
- It is not currently approved for pediatric use but may benefit children with refractory epilepsy.
Purpose of the Study:
- To evaluate the efficacy and tolerability of levetiracetam as add-on therapy in children with refractory epilepsy.
Main Methods:
- An open-label study involving 39 pediatric patients (mean age 8.6 years) treated with levetiracetam for up to 9 months.
- Data collected included seizure frequency, drug dosages, adverse events, and neurological examinations.
Main Results:
- Levetiracetam effectively reduced seizure frequency across various types, particularly partial-onset seizures.
- Ten patients reported improvements in cognition or behavior; 14 were discontinued due to lack of efficacy or adverse events.
Conclusions:
- Levetiracetam appears generally effective and well-tolerated in children with refractory epilepsy.
- Positive effects on cognition warrant further investigation in larger, controlled studies.
Abstract:
Levetiracetam, one of the newer-generation antiepilepsy drugs, is not currently approved for use in children. Given its favorable efficacy, pharmacokinetic, and, particularly, safety profile in adults, we felt that it may be a useful antiepilepsy drug for children with refractory epilepsy. We treated 39 patients (mean age 8.6 years) with open-label levetiracetam for up to 9 months. Seizure frequency, drug dosages, adverse events, and neurologic examinations were documented at baseline and routine follow-up visits. Levetiracetam, as add-on therapy, was effective in reducing seizure frequency in a variety of seizure types but was most effective for partial-onset seizures. Fourteen patients were discontinued for lack of efficacy or adverse events. Ten patients reported improvements in cognition or behavior. Levetiracetam was generally effective and well tolerated in this open-label study. Its apparent positive effects on cognition in some patients are encouraging. Large, well-controlled studies are needed to fully define levetiracetam's potential in children with refractory epilepsy.