Abstracts

Levetiracetam (LEV, Keppra[reg]) is an antiepileptic drug (AED) approved as adjunctive therapy in the treatment of partial-onset seizures in adults with epilepsy. The purpose of this study was to evaluate the use of LEV in pediatric epilepsy patients referred to an academic medical center. Patients in this study were children with intractable seizures despite appropriate treatment with AEDs other than LEV.
The study enrolled 22 patients ranging in age from 2 to 16 years, all of whom took Keppra for a minimum of 4 months.
Of these, 6 had partial-onset seizures, and 16 had primary generalized seizures. The majority of patients were taking 3 (95%) concomitant AEDs when LEV therapy was initiated. Associated conditions included malformations of cortical development, perinatal or post-traumatic sequela lesion, hemiatrophy and agenesis of the corpus callosum. One patient had vagus nerve stimulators which was turn off when LEV was initiated. The average therapeutic dose was 31 mg/kg (range 15-60 mg/kg). Of the 22 patients, 21 tolerated LEV at doses higher than the initial dose and were included in the efficacy analysis. Two patients became seizure free (9.5%). Thirteen (62%) achieved 50% or greater seizure reduction. Of these 21 patients, 17 were taking concomitant AEDs and 2 of 17 were on more than 3 drugs. 71.5% of patients who tolerated LEV therapy had a significant decrease in seizure frequency.
This study supported LEV[rsquo]s efficacy in partial-onset epilepsy (83%) and a good improvement in generalized epilepsy (66%).
LEV was well tolerated in the majority of patients (95%) in this population of children with intractable partial-onset or generalized epilepsy.
In addition, a number of patients with behavior disorders showed a significant improvement with this behavior, as noted by parents.