Levetiracetam as add-on therapy in generalised epilepsies

Levetiracetam is highly effective as add-on treatment in refractory partial-onset seizures but there are only limited data supporting its benefit in generalised epilepsies. We have reviewed the clinical records of 25 consecutive adult patients with generalised epilepsies (84% females; mean age 34 (range 16-75) years) prescribed levetiracetam for at least six months. The epilepsy was considered idiopathic in 22 patients (88%)--including 13 with juvenile myoclonic epilepsy--and symptomatic in three. Most patients (68%) reported some improvement in seizure frequency on levetiracetam including 16% who became seizure free. Levetiracetam was generally well tolerated although 11/25 (44%) of patients reported some tiredness, weight change or rash. Levetiracetam was stopped in five patients, four because of side effects and one though lack of efficacy. In four cases, pre-existing antiepileptic medication was withdrawn, leaving levetiracetam as monotherapy. We conclude that levetiracetam is a useful add-on treatment for patients with refractory generalised epilepsies.