Abstracts

Rationale: Children with intractable epilepsy have frequent hospital admissions because of status epilepticus and acute repetitive seizures. Seizures are also seen in the neonatal period and are a major indicator of future adverse neurological sequelae. Intravenous (IV) levetiracetam became available in August 2006 in patients aged 16 years and above. There is not enough data about safety and tolerability in children. We retrospectively analyzed data at our institution of children who received IV levetiracetam for acute seizure management. Methods: The goal of this study is to retrospectively assess the efficacy and tolerability of IV levetiracetam therapy in acute seizure management in children. Methods: A retrospective chart review was conducted on all preterm neonates, term neonates, and children less than 18 years of age who received IV levetiracetam at Scott and White Hospital/Texas A & M HSC College of Medicine, Temple, TX. Subject data were acquired from electronic medical records. Approval of this retrospective analysis was given by our hospital's Institutional Review Board. Results: A retrospective chart review was conducted on all preterm neonates, term neonates, and children less than 18 years of age who received IV levetiracetam at Scott and White Hospital/Texas A & M HSC College of Medicine, Temple, TX. Subject data were acquired from electronic medical records. Approval of this retrospective analysis was given by our hospital's Institutional Review Board. Results: We retrospectively analyzed 200 patients who met our inclusion criteria for neonatal seizures, status epilepticus and acute repetitive seizures and received IV levetiracetam. There were 104 (52%) males and 96 (48%) females. The loading dose of IV levetiracetam was 50 mg/kg in most patients, followed by a maintenance dose of 25 mg/kg every 12 hours. The dose was infused over 15 minutes to an hour. The primary objective was to assess response based on clinical and electro graphic documentation. The secondary objective was to assess the indication of initiation of this medicine, adverse events, and seizure control at well child visits. Response to levetiracetam was favorable. 170 (85%)out of 200 patients reached seizure freedom within 24 hours and 16 (7.44%) within 72 hours. Seizures continued after 72 hours in 14 patients requiring additional anticonvulsants. No serious side-effects were apparent. No serious adverse events were reported with any of the patients, 35 patients (20.7%) reported behavioral changes (irritability) while on levetiracetam. 14 patients were lost to follow-up . Patients were switched to oral levetiracetam after discharge from the hospital . The duration of follow up ranged from 6 months to 5 years Conclusions: IV Levetiracetam seems to be efficacious in acute seizure management in children. Funding: none