Abstracts

The objective of this study is to evaluate the efficacy and tolerability of levetiracetam in children when given at bedtime and as monotherapy in children with proven epilepsy. This is a single center open-label study of 5 children, age 5 months to 7years, (mean 2.1). In all cases monotherapy was given once a day from the start. All children presented to the PICU in status epilepticus. The diagnosis was based on bedside EEG. Three children had generalized seizures and two had multifocal seizures. Levetiracetam was administered through a nasogastric tube while children were in a postictal state and only benzodiazepines were given concomitantly. Levetiracetam therapy was continued orally when the state of alertness improved. The starting dose was 40-60 mg/kg/day. The follow-up period varied from 6 to 14 months (mean 9). No patient stopped levetiracetam due to side effects or lack of efficacy. Four patients had complete remission of the clinical seizures. Their routine follow-up EEG became normal in 2 patients. Two patients continued to show a focal slowing due to the underlying ventriculomegaly. One patient with Niemann-Pick disease type C continued to show clinical and electroencephalographic evidence of epilepsy. Levetiracetam monotherapy given once at bedtime is well tolerated in this small group of patients. Efficacy is less likely in a patient with progressive encephalopathy.