Abstracts

The purpose of this study was to assess the efficacy and safety of levetiracetam in children with idiopathic generalized epilepsy. A previous review showed levetiracetam to be most effective in children with partial onset seizures as well as being well tolerated with few reported side effects. Preliminary studies show levetiracetam to be effective for treating idiopathic generalized epilepsy in adult patients but few results are available in children with generalized idiopathic epilepsy., A retrospective chart review was performed in a tertiary center on children ages 2-18 years old with idiopathic generalized epilepsy that have been treated with levetiracetam up until May 2006. The data included patients with idiopathic generalized epilepsy for example, myoclonic, tonic, and atonic seizures. Pure absence seizures were excluded but absence mixed with other convulsive types were accepted. Also excluded were patients with symptomatic and partial seizures. Data was recorded on: patient age, gender, type of epilepsy, existing anti-epileptic therapy, dose and duration of treatment with levetiracetam, patient/caregiver assessment of seizure frequency, and adverse events., A total of 15 patients fulfilled the inclusion criteria of this study.
Daily levetiracetam dose ranged from 9.1 to 73.2 mg/kg/day (average 35.2 mg/kg/day). The mean number of concomitant use of other anti-epileptic drug (AED) was 0.9 which included lamotrigine, primidone, oxcarbazepine, valproic acid, carbamazepine, phenytoin, topiramate. The mean number of total AEDs per patient was 1.6. The demographic characteristics included: Age: 2.3-18 years (mean, 10.6 years), Sex: 9 females, 6 males, Generalized tonic clonic 11/15 (73.3%), Absence (mixed type) 6/15 (40%), Myoclonic 5/15 (33.3%), Tonic 1/15 (6.7%), Atonic 2/15 (13.3%).
Nine out of fifteen patients (60%) showed a good response to levetiracetam with reduction in seizure frequency. Four out of fifteen patients (26.7%) became seizure free and 5/15 (33.3%) patients had fewer seizure frequency with therapy.
Five out of fifteen patients (33.3%) had no response to therapy.
Of those with generalized tonic clonic epilepsy, 4/11 (36.4%) had become seizure free, 3/11 (27.2%) had a decrease in seizure frequency, and 3/11 (27.2%) showed no response.
Adverse effects occurred in four children (26.6%) including behavioral change (1/15), tiredness (1/15), decrease appetite (1/15), and reason unknown (1/15) (child was seen as an in-patient and followed at an outlying hospital)., Treatment with levetiracetam resulted in reduction of seizure frequency in 60% of the patients included in this study. Levetiracetam was efficacious and safe for use in children with idiopathic generalized epilepsy with few, mild side effects reported., (Supported by UCB Pharma.)