Efficacy and safety of levetiracetam: An add-on trial in children with refractory epilepsy

Abstract

The aim of this multicentric, prospective and uncontrolled study was to evaluate the efficacy and safety of levetiracetam in 110 children with refractory epilepsy, of whom 21 were less than 4 years old. After a median follow-up period of 7 months, levetiracetam administration was effective (responders with >50% decrease in seizure frequency) in 39% of children, of whom 10 (9%) became seizure-free. The efficacy was higher in patients with localization-related epilepsy (58% of responders) than in those with generalized epilepsy (37% of responders). Levetiracetam was well tolerated. The main side effects of somnolence and irritability occurred in 14% of patients. In one patient acute choreoathetosis occurred after few doses of levetiracetam. Overall, the adverse effects were not severe. Children younger than 4 years were particularly tolerant. In conclusion, the present study confirms that levetiracetam is effective and well tolerated as an add-on treatment in children with refractory epilepsy. Our preliminary data also indicate that levetiracetam may be a valid therapeutic option for epilepsy in infants and young children.

Add-on Levetiracetam in Children With Refractory Epilepsy: A Systematic Review

“…They believed that mental retardation and physical handicap among their studied population played a role as a risk factor for experiencing somnolence during LEV treatment (2). It was the most common side effect reported by the seven of the reviewed articles (2, 10, 11) Behavioral and emotional changes were also reported as the most common cause of withdrawal of LEV (2,11,17,28). Younger patients were reported to be more susceptible to side effects, specially behavioral and emotional changes compared to the large phase III studies in adults (19,29,30).…”

“…Kanemura et al reported the response rate of 54.1% (16). Grosso et al reported that levetiracetam administration was effective (responders with > 50% decrease in seizure frequency) in 39% of children, of whom 10 (9%) became seizure-free (11). The study by Lagae et al showed seizure frequency reduction of more than 50% in 47% of children very early after introducing the LEV.…”

“…Moreover, LEV administration in children was associated with low discontinuation rates due to adverse effects. The most common reported adverse effects were mild and reversible (2,(11)(12)(13)(14)(15). Although previous trials demonstrated the efficacy of LEV both in adults and children, safety and efficacy of LEV in infancy remains ascertained.…”

The Application of Density Spectral Array Monitoring in Digital Electroencephalography for Levetiracetam-Induced Non-Convulsive Status Epilepticus in a Patient with Lennox-Gastaut Syndrome

“…Increasing the dose of CLB dose was effective for seizure control and NCSE cessation, although benzodiazepines have been reported to occasionally aggravate tonic seizures [1,10]. The major side effects of LEV have been reported to be mostly mild and transient in nature, and include irritability, aggression and somnolence [3][4][5][6]10]. Recently, however, some patients with refractory childhood epilepsy (e.g.…”

“…In contrast, levetiracetam (LEV) is novel anticonvulsants with diminished risks for harmful risks for drug-drug interactions because of its lack of interference with the metabolism of other drugs [3][4][5][6]. Its efficacy and tolerability with regard to improvement in patient' QoL and seizure-control in various refractory epilepsies, including LGS, have been evaluated in several reports [5,7,8].…”