Abstracts

Levetiracetam (LEV) is a new antiepileptic drug proved to be effective as add-on therapy to other AEDs in reducing partial onset seizures. The objective of this study was to evaluate the efficacy and tolerability of levetiracetam monotherapy in generalised idiopathic epilepsies of childhood and adolescence, particularly those showing photosensitivity. This is a single centre open-label study in 21 patients, ages 5.5-21.5 years. LEV monotherapy was commenced as the AED initial therapy in 16 patients and in 5 after valproate withdrawal mainly because of adverse events. The epilepsy diagnosis was based on sleep-wake video-EEG recordings. The children were classified according to their seizure type and photosensitivity. Seventeen (17) patients had generalised tonic clonic seizures (GTCS), absences and myoclonic jerks. One (1) GTCS and absences, one (1) absence seizures only, and two (2) absences and myoclonic seizures. LEV was commenced at a starting dose of and 5-10mg/kg/day gradually increased to 35-45 mg/kg/day, (dependent on clinical effect or adverse events). The follow up period varied from 3 to 30 months. Seven (7) patients (39%), 5 of whom were photosensitive, had a complete clinical/ EEG response. The follow up period was 5 to 28 months. Mean daily LEV dose was 24[plusmn]8 mg/kg/day. Four (4) photosensitive patients had complete clinical and 50-80% EEG response. In 6 patients on LEV, after a period of 3 to 6 months, valproate in 5 and lamotrigine in 1 were added, for complete or improved clinical response. In 4 patients the results varied from 30-50% at a mean daily dose of 15-25mg/kg/day. One patient with absence and myoclonic seizures deteriorated and was changed within one month to valproate with good response. Adverse events were few, transient and due to faster titration. Levetiracetam monotherapy is effective, well tolerated and safe in idiopathic generalised epilepsies and photosensitivity in children and young adults. The maximum effective dose needs to be established.