Abstracts

Levetiracetam was approved in 1999 as adjunctive therapy in adults with partial seizures with or without secondary generalization. The precise mechanism by which levetiracetam exerts its effects is unknown but it does not appear to be related to the mechanisms of current drugs. The objective of this study is to assess the efficacy of levetiracetam in children ages 16 and under with partial seizures. A retrospective chart review was performed for 16 patients ages 16 years and under with partial seizures who had received levetiracetam as adjunctive therapy over the past three years. The mean age of patients when levetiracetam was initiated was 10 (age ranged between 3 and 16 years old). 9 patients had partial seizures (PS), 4 had primary generalized seizures (GS), and 3 had Lennox Gastaut Syndrome (LGS). Of the 16 patients, 7 (43.75%) experienced [ge]50% reduction in seizure frequency. The average starting dose was 11.44 mg/kg bid (doses ranged between 5.7mg/kg bid and 22.9mg/kg bid). The mean maintenance dose in the 7 patients who improved was 33.1 mg/kg daily. Levetiracetam was added to 2 antiepileptic drugs (AED) in 3 patients and 1 AED in two patients. Three patients with PS and one patient with LGS had their previous AEDs stopped due to side effects including rash and difficulty swallowing the other AEDs. The three patients with PS remain seizure free while the patient with LGS has had a [ge]50% reduction in seizure frequency. Two patients had a vagal nerve stimulator. Seven patients discontinued the medication secondary to adverse side effects including increase in number of seizures (3), personality change (3), increased infections (1). One patient discontinued due to lack of efficacy and one was lost to follow up. Levetiracetam is effective when used as adjunctive therapy in children ages 16 years and under with partial seizures.