Abstracts

Rationale: Intravenous (IV) levetiracetam (LEV) was recently approved in the US by the FDA for treatment of patients with epilepsy older than 16 years. There is little data on the efficacy and safety of IV LEV in children.Methods: A retrospective chart review of patients treated with IV LEV between March and May 2007 at our tertiary care children’s hospital was performed. The following information was gathered: demographic data, underlying disorders, indication, dose and duration of treatment, concomitant antiepileptic drugs (AEDs), seizure control, and side effects. Results: We identified 10 children, 14 M and 6 F, ages 3 weeks to 19 years, who were treated with IV LEV. The most common indication for IV LEV was control of acute repetitive seizures/status epilepticus (SE) in 4 (40%) patients, three of whom had failed other AEDs; the fourth was allergic to multiple AEDs. Three (30%) patients were on oral LEV at presentation and received IV LEV as a temporary measure because of intercurrent illness (breakthrough seizures in 2 and pancreatitis in 1). One patient was treated with IV LEV for seizure prophylaxis after an acute symptomatic seizure secondary to stroke. One patient received IV LEV for seizure prophylaxis in the peri-operative period for brain biopsy. In another patient IV LEV was given as a substitute for sodium valproate because of severe thrombocytopenia. The mean dose of IV LEV used in our patients was 50 mg/kg/day (range 20-115 mg/kg/day). Mean duration of treatment was 4.9 days (range 1-16 days). Three (75%) of the 4 patients, treated for control of acute repetitive seizures/SE, had no further seizures, and the other patient had a significant decrease in seizure frequency. None of the 3 patients who were temporarily switched from oral to IV LEV had seizures. The patient who was switched from oral sodium valproate to IV LEV, the patient who received IV LEV for prophylaxis for brain biopsy, and the patient who was treated following an acute symptomatic seizure remained seizure free. No adverse events were noted during IV LEV therapy, and none of the patients required discontinuation of the treatment. Conclusions: These preliminary results suggest that IV LEV is safe and effective in children with seizures in different settings, including the treatment of acute repetitive seizures and status epilepticus. Larger prospective studies on safety and efficacy of IV LEV are warranted