Abstracts

Patients with juvenile myoclonic epilepsy (JME) may be resistant or show adverse effects to valproate. Several reports and open label studies have pointed out the efficacy of levetiracetam in generalised epilepsy (Patsalos, 2004). Moreover, levetiracetam has been shown to be effective in preventing photoparoxismal response in subjects with photosensitive epilepsy (Kasteleijn-Nolst Trenité et al., 1996). Our previous open-label study suggested levetiracetam might be effective and well tolerated in resistant cases of JME or may become a reasonable alternative to valproate in newly diagnosed patients. We present a multicentre, prospective, long-term, open-label study evaluating the effects of levetiracetam on EEG epileptiform abormalities and on the photoparoxismal response in patients affected by JME., Ten patients with newly diagnosed and 38 resistant/intolerant to previous AEDs JME were enrolled. After a 8 week baseline period, levetiracetam was titrated in 2 weeks to 500 mg b.i.d. and then increased up to 3000 mg/day according to the patient[apos]s response. An EEG evalutation has been performed before starting the treatment and every 3 months. Efficacy parameters were: reduction or sopression of interictal epileptiform abnormalities and photoparoxismal response., The overall mean dose of levetiracetam was 2208 mg/day. The mean study period was 19 (range 0.3-38) months. Four patients had a normal EEG before starting the treatment, 41 had diffuse/generalized spike-waves and 11 showed a severe phoparoxismal response. After drug administration 27 patients had a normal EEG, 20 showed diffuse/generalized spike-waves discharges which were judged to be less frequent and wide, and in 4 we had the persistence of phoparoxismal response. The mean monthly frequency of DWM and of GTC seizures in the entire group was significantly reduced after levetiracetam., This open-label study suggests levetiracetam may be effective in reduction of epileptiform abnormalities, it suppress the photoparoxismal responce and it is well tolerated in resistant cases of JME or may become a reasonable alternative to valproate in newly diagnosed patients.,