Abstracts

Levetiracetam (LEV) is a new antiepileptic drug (AED) approved as adjunctive therapy in children older than 4 years with partial or secondary generalized epilepsy. Myoclonic seizures are often difficult to control requiring several AEDs. Studies in juvenile myoclonic epilepsy have shown good response of myoclonic seizures to LEV. The use of LEV in myoclonic seizures due to symptomatic generalized epilepsy in children is scarce. The objective of this study was to evaluate the efficacy and tolerability of LEV in the treatment of this type of seizures in children., We retrospectively reviewed the records of children with myoclonic seizures due to symptomatic generalized epilepsy, who were treated with LEV at our institution between 2003-2005. Reduction of myoclonic seizures was assessed., Twelve patients (9M, 3F), mean age 7.2 years (range: 2-12) were identified. Two of them had myoclonic seizures only, while ten had additional types of seizures including tonic, tonic-clonic, complex partial, and drop attacks. Eleven patients had developmental delay, mental retardation or learning disability. Mean LEV dose was 39 mg/kg/day (range: 21-69 mg/kg/day), mean number of previous AEDs 2.6 (range 0-7), and mean number of concomitant AEDs 1.63 (range 0-3). One patient was on monotherapy. Mean follow up was 12 months. Myoclonic seizure reduction was as follows: 100% in 1, 75-99% in 2, 50-74% in 2, 25-49% in 3, and [lt]25% in 3. Overall, forty two percent of patients had 50% reduction in myoclonic seizures. Side effects included transient drowsiness in 2, and behavioral problems requiring discontinuing LEV within a month of therapy in 1., LEV proved to be effective and safe in our group of children with myoclonic seizures due to symptomatic generalized epilepsy. Further studies are necessary to assess the use of LEV monotherapy or polytherapy in myoclonic seizures in children.,