Abstracts

RATIONALE: To retrospectively examine the effectiveness of adjunct levitiracetam(LVT)therapy in children with refractory generalized epilepsy.
METHODS: Patients with refractory generalized epilepsy treated with adjunct LVT were evaluated retrospectively through chart reviews and parent interviews. Data collected on each patient included age, epilepsy classification, dose, concomitant therapies, response to therapy, side effects and length of therapy. Response and side effects were based on parent report. Patients had to be on LVT at least 4 weeks to be included.
RESULTS: 18 patients were identified with an average age of 10.3 years. Two were excluded because they were on LVT less than 4 weeks. Epilepsy types included: 11 Lennox-Gastaut syndrome(LGS), 2 myoclonic-astatic epilepsy, 2 childhood absence, 1 myoclonic epilepsy. Average length of therapy was 2.5 months (range 1-6 months). Concomitant treatments included valproate(5), lamotrigine(10), topiramate(6), zonisamide(3), and vagal nerve stimulation(2). Average dose was 29mg/kg/day(range 15-52mg/kg/day). At least a 50% reduction in seizure frequency was reported in 10 patients with 6 reporting a greater than 75% reduction. Three were seizure-free (1 absence, 1 myoclonic, 1 myoclonic-astatic). Among the patients with LGS, 6 had a greater than 50% seizure reduction. Side effects were reported in 6 patients(30%). These included decreased appetite(2), asthenia(1), behavioral changes(3). No patient discontinued LVT due to side effects.
CONCLUSIONS: In this population of children with a variety of refractory generalized epilepsies, levitiracetam, at least in the short term, appears to be a well tolerated, efficacious adjunct agent. This includes disorders such as LGS and myoclonic astatic epilepsy. Side effects are relatively uncommon and generally mild in nature. Larger prospective studies evaluating efficacy in the management of these specific epileptic syndromes need to be performed to further establish.