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Levetiracetam may be more effective for late-onset partial epilepsy
Carl W Bazil1, Andrew Rose, Stanley Resor
1Comprehensive Epilepsy Center, Department of Neurology, Columbia University, New York, NY 10032, USA. cwb11@columbia.edu
Background:
Many agents are available for treating epilepsy; however, population studies have failed to show overall differences in efficacy for a given seizure type. Clinical experience suggests that certain individuals will respond to a given agent while others with the same seizure type will not.
Objectives:
To examine a population of patients who received one of the newer antiepileptic drugs, levetiracetam, and to identify those who had either a dramatic improvement or a significant worsening of seizures.
Methods:
Retrospective medical record review of patients with refractory epilepsy.
Results:
Patients who responded well to levetiracetam therapy were older at the onset of epileptic seizure than those who did not (mean [SD] age, 51 [5] vs 27 [3] years; P<.05). This was also true of the subset of patients who had localization-related epilepsy. Patients with temporal lobe onset were likely to do well whereas patients with frontal lobe onset were not.
Conclusions:
These results suggest that certain subpopulations may be particularly likely to respond to levetiracetam therapy. These need to be confirmed in a larger prospective trial; however, looking for specific characteristics of patients who respond to certain drugs may lead to useful guidelines for drug choices in treating epilepsy.