Abstracts

Levetiracetam (LEV) is a pyrrolidone derivative, approved in 1999 in USA and in 2000 in Europe. Previous studies have shown its efficacy and tolerability as adjunctive therapy in focal epilepsies in children, adolescents and adults with and without secondary generalisation. More recent reports seem to suggest its efficacy on generalised seizures in the context of idiopathic epilepsies. The aim of our study was to report on the efficacy and the tolerability of LEV monotherapy in idiopathic generalized epilepsy (IGE) in an unselected group of adolescents who attended the epilepsy services of the participating hospitals in the period Jan 2002-Dec 2003. we have followed-up 11 patients (4M and 7F), with a mean age 14.9 (age range 12-17), with IGE. Four patients had IGE with grand mal seizures on awakening and 3 of these were photosensitive. Seven patients had juvenile myoclonic epilepsy (JME), all of them photosensitive. Therapeutic dose was between 1000 and 1500 mg/day (mean dose 1313,6 mg/day) for all patients. Follow-up ranged between 12 and 22 months. During every follow-up visit we administered a questionnaire about side effects to evaluate tolerability to Levetiracetam. At the last observation all patients were seizure-free, and a complete abatement of photoparoxysmal EEG response was achieved in the 10 patients with photosensitivity. In a single patient a significant, although transient somnolence was reported, which required slowing of the titration. our experience, albeit on a small sample, seems to suggest that LEV can be extremely effective and well tolerated as monotherapy in patients generalized seizures. The remarkable effect on photosensitivity confirms anecdotal data from previous studies. Our encouraging results, if confirmed by blinded studies using appropriate randomisation, suggest that LEV has the potential to be considered as first-line treatment particularly in adolescent females with JME, given the well-known potentially teratogenic effect of sodium valproate.