Abstracts

Levetiracetam is an antiepileptic drug approved as adjunctive therapy in the treatment of partial onset seizures in adults with epilepsy. The purpose of this study was to review our clinical experience with levetiracetam in the different epilepsies in the adult population referred to an academic center. Adult patients with persistent seizures despite adequate exposure to other AED(s) were started on 500mg BID and titrated levetiracetam up to 3gm per day. These patients were followed for efficacy ([gt]50% seizure reduction) and adverse effects. 45 patients who range in age from 16 to 88 years were entered into the study. Seizures were classified as primary generalized (N=3) and partial (N=21). 2 Patients had Lennox-Gastaut syndrome (LGS). Associated conditions included schizencephaly, CVA, Cavernous angioma, HIV,SLE, Hx of intracranial hemorrage, and an astrocytoma. 8 patients had Vagal Nerve Stimulators. All patients were on two or three AED(s) when levetiracetam was added. Mean duration of treatment at the last clinic visit was 12.2 months. 37 patients had improvement in their seizure frequency. Four achieved 100% seizure control, and one patient developed a rash leading to discontinuation. Efficacy of [gt]50% seizure control was reported in 33% of the patients using levetiracetam as adjunctive therapy to one or two other AED(s). Six out of the ten patients showing improvement were also receiving Dilantin. Seven out of the eleven were receiving carbamazepine. Only one out of the eleven were receiving both phenytoin and carbamazepine. No patients demonstrated worsening of their seizures while on levetiracetam. The most common reported side effects were fatigue, dizziness and confusion. No patients with primary generalized epilepsy showed benefit. One patient with VNS showed improvement on levetiracetam. One patient was tapered off all other AEDs Levetiracetam is well tolerated in the majority of patients (82 %) in this population of adults with generalized and partial onset epilepsy. Approximately had had significant decrease in seizure severity and frequency. One patient with LGS showed improvement. The remaining patients who showed improvement had partial epilepsy. One patient with VNS showed improvement as well. None of the patients with primary generalized epilepsy showed improvement.