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Levetiracetam in children with refractory epilepsy: lack of correlation between plasma concentration and efficacy

Patricia C Giroux1, Milagros Salas-Prato, Yves Théorêt

  • 1Department of Physiology, University of Montreal, C.P. 6128, succursale Centre-ville, Montréal, Québec, Canada. patricia.giroux@umontreal.ca

Seizure
|June 24, 2009
PubMed

Insights

Levetiracetam (LEV) effectively reduces seizure frequency in children with refractory epilepsy, demonstrating a favorable safety profile. Blood level monitoring did not show a clear correlation with treatment efficacy in this pediatric population.

Area of Science:

  • Pediatric Neurology
  • Clinical Pharmacology

Background:

  • Refractory epilepsies in children pose significant treatment challenges.
  • Levetiracetam (LEV) is an established antiepileptic drug with a broad spectrum of action.

Purpose of the Study:

  • To assess the efficacy and tolerability of levetiracetam (LEV) as adjunctive therapy for pediatric refractory epilepsies.
  • To evaluate the utility of monitoring levetiracetam plasma concentrations in children with epilepsy.

Main Methods:

  • Retrospective review of medical files for 69 children treated with LEV.
  • Analysis of LEV efficacy, tolerability, and adverse events.
  • Plasma concentrations measured via HPLC-UV in a subgroup, correlated with dosage and clinical response.

Main Results:

  • 74% of patients experienced >50% seizure reduction, with 23% seizure-free.
  • Adverse events were mild-to-moderate in 26% of patients.
  • No clear correlation found between levetiracetam plasma concentration and seizure control.

Conclusions:

  • Levetiracetam is an effective broad-spectrum anticonvulsant for pediatric refractory epilepsy.
  • LEV demonstrates a favorable safety profile in children.
  • Therapeutic drug monitoring of LEV plasma levels may not be essential for optimizing efficacy in this population.
Abstract

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