Levetiracetam Monotherapy and its Combination with Phenytoin: Exploring Novel Biomarkers in Pediatric Epilepsy

Epilepsy is a neurological disorder characterized by recurrent seizures that can cause long-standing disturbance of normal brain function. It may adversely affect academic performance, behavior, emotional adjustment, social adaptability, and overall development in children. Neurotrophic factors and inflammatory markers are believed to play key roles in the pathogenesis of epilepsy. This study evaluated the effect of levetiracetam monotherapy and its combination with phenytoin on serum brain-derived neurotrophic factor (BDNF) levels, Interleukin-2 (IL-2) levels, and social adaptability/development in children with epilepsy.

Children with epilepsy, aged 1 to 12 years, were given levetiracetam monotherapy (n=30) and combination therapy of levetiracetam and phenytoin (n=30) for 20 weeks. Healthy controls (n=30) were also included. Serum BDNF and IL-2 levels were assessed at baseline and 20 weeks, along with social adaptability and development, using the Vineland Social Maturity Scale (VSMS) and Developmental Screening Test (DST) scores, respectively.

Pretreatment, serum BDNF and IL-2 levels were significantly (p <0.001) lower and higher respectively, in both treatment groups compared to controls. After 20 weeks, BDNF and IL-2 levels were significantly (p <0.001) increased and decreased, respectively, in the monotherapy group and combination therapy group. VSMS and DST scores improved significantly (p <0.001).

The findings suggest that levetiracetam and its combination with phenytoin modulate neurotrophic and inflammatory pathways in pediatric epilepsy, with parallel improvements in social and developmental outcomes.

Levetiracetam monotherapy and its combination therapy with phenytoin increased serum BDNF levels, decreased IL-2 levels, and improved VSMS and DST scores in pediatric epilepsy patients, suggesting that these treatments influence epileptogenesis.