Abstracts

Levetiracetam (LEV) is a newer antiepileptic drug (AED) approved as add-on in adults with partial epilepsy. There are few studies of its use as add-on in children with partial epilepsy and there is no data on its use in children as monotherapy. The objective of this study was to evaluate the efficacy and tolerability of levetiracetam as monotherapy in a cohort of children with epilepsy. A retrospective record analysis of children attending the Neurology Clinic at this institution identified 81 patients with epilepsy who received LEV between 2002-2005. Nineteen children with ages ranging from 2.5-18 years received LEV as monotherapy. Seventeen of 19 children were on LEV monotherapy for the following indications; unacceptable adverse effects with other AEDs, n=10, poor seizure control with prior AED, n = 5, initial monotherapy, n=2. Two additional children converted to LEV monotherapy after successful seizure control with addition of LEV as adjunct. Fourteen children had partial epilepsy and 5 had generalized epilepsy. Dose range was 14 [ndash]60 mg/kg. Duration of therapy with LEV ranged from 2-24 months with a mean of 10.4 months. 11/18 children (61%) with follow up data were seizure free on LEV, 67% had greater than 50% reduction in seizures and 33% had no change in seizure frequency. The only adverse effect noted was worsening of behavior and irritability seen in 22%. LEV was discontinued in a total of 7 children, for poor seizure control in 5 and behavioral side effects in 2. Two children who remained seizure free for a total of 2 years on LEV monotherapy have been successfully weaned off as well. LEV appears to be effective and well tolerated as monotherapy in children with epilepsy. (Supported by an investigator initiated research grant given to Dr. Khurana by UCB-Pharma.)