Levetiracetam efficacy in children with epilepsy with electrical status epilepticus in sleep

Area of Science:

• Pediatric Neurology
• Epileptology
• Clinical Neurophysiology

Background:

• Epilepsy with electrical status epilepticus in sleep (ESES) is a severe epileptic encephalopathy.
• Effective treatment options for ESES remain limited, necessitating research into novel therapeutic strategies.

Purpose of the Study:

• To evaluate the efficacy and safety of levetiracetam (LEV) in treating pediatric patients with ESES in China.
• To assess the impact of LEV on seizure frequency, EEG patterns, and neuropsychological function in ESES patients.

Main Methods:

• Retrospective analysis of clinical data from 71 pediatric patients with ESES treated with LEV (30-50mg/kg/day).
• Serial EEG recordings and neuropsychological evaluations were conducted for 3-75 months post-treatment initiation.
• Patient data included seizure status, EEG response, functional recovery, and adverse events.

Main Results:

• A >50% seizure frequency reduction was observed in 70% of patients with initial seizures.
• EEG improvement occurred in 45% of patients within 3-4 months, with 5 achieving normalization.
• Despite initial responses, 66% of patients continued to suffer from ESES, and only 13% regained baseline function; LEV was well-tolerated.

Conclusions:

• Levetiracetam (LEV) is a safe option for treating ESES syndrome.
• While LEV can reduce seizure frequency, its overall efficacy on EEG and neuropsychological outcomes in ESES is limited.
• Treatment response was associated with ESES duration, age at onset, and epilepsy etiology.