Abstracts

The incidence of epilepsy is highest in the first year of life, and declines throughout childhood and adolescence. While several new antiepileptic medications have been introduced in the last ten years, only three medications have indications for the treatment of children younger than 4 years of age. Levetiracetam is a novel antiepileptic medication approved as add-on therapy for partial seizures in children older than 4 years of age. Levetiracetam may be tolerable in children younger than 4 years old and, therefore, provide an alternative treatment for patients in this age group., Retrospective chart review of 587 children less than 4 years old diagnosed with epilepsy and followed at the Emory University Children[apos]s Center over a 5 year period yielded 122 patients (age 1-48 months) treated with levetiracetam., Epilepsy types included partial (52%) and generalized (27%) epilepsy, with 21% unclassified. Levetiracetam was initiated as monotherapy in 48 (39%) patients, with 55 patients (45%) on monotherapy by the end of the study period. Levetiracetam was introduced at an average dose of 24 mg/kg/d (range 7-83mg/kg/d) and titrated to an average maximum dose of 45 mg/kg/d (range 9-187 mg/kg/d). Seizure freedom was achieved for at least 6 months in 56 patients (46%) and greater than 1 year in 38 (31%) of all the patients reviewed. Within the monotherapy group, 24 (50%) remained seizure free for at least 6 months and 17 (35%) remained seizure free over one year. Levetiracetam was well tolerated, as 70% of the patients continued the medication throughout the follow-up period (range 6-57 months). The most common side effect requiring discontinuation of levetiracetam was irritability (9%)., This retrospective review demonstrates levetiracetam is a tolerable medication which may be efficacious in the treatment of epilepsy for children less than 4 years of age. Levetiracetam offers an important treatment alternative in this age group., (Supported by UCB Pharma, Inc. Smyrna, Georgia.)