Recent updates on Levetiracetam

Abstract

To review recent clinical evidence available for levetiracetam in the treatment of various types of epileptic seizures. A literature search was conducted to identify clinical studies conducted after 2015 with Levetiracetam. In patients with focal epilepsy, Levetiracetam was found to be as effective as Carbamazepine, Clobazam, and Valproic acid but with better tolerability than Carbamazepine. Levetiracetam could be used as monotherapy in the treatment of new-onset focal epilepsy. It probably has a neuroprotective benefit, particularly important in neonates and children. The safety and tolerability of Levetiracetam are more apparent during pregnancy. Thus, the adverse event profile is largely in favor of Levetiracetam in comparison to standard older AEDs. Meta-analysis has confirmed that Levetiracetam is significantly better in terms of withdrawal rates compared to the older AEDs, hence may be considered as the first line in new-onset focal epilepsy in adults and the elderly. Levetiracetam may be a better option as an add-on treatment in children with partial seizures, due to its favorable efficacy and insignificant toxicity than Oxcarbazepine and Topiramate. Recent evidence suggests that Levetiracetam could be a potential first-choice, second-line AED for Benzodiazepine resistance status epilepticus with efficacy comparable to established older AEDs. It improves the quality of life due to higher rates of seizure freedom and favorable tolerability profile. Levetiracetam has the potential for being a first-line AED and has also proven to be a better adjunctive considering the recent efficacy and safety outcomes.

The analgesic efficacy of ultrasound-guided erector spinae plane block versus ultrasound-guided caudal epidural block for abdominal surgery in pediatric patients – A patient and assessor-blind, randomized controlled study

“…have also recently advised judgment while choosing this block, because of unproven efficacy, for procedures where moderate to severe pain is expected and other gold-standard options are available. [ 22 ]…”