Efficacy and tolerability of levetiracetam for pediatric refractory epilepsy

• Published in: Brain & development (Tokyo. 1979) Vol. 39; no. 3; pp. 231 - 235
• Main Authors: Muramatsu, Kazuhiro, Sawaura, Noriko, Ogata, Tomomi, Makioka, Nishiki, Tomita, Keiko, Motojima, Toshino, Ida, Kuniko, Hazama, Kyoko, Arakawa, Hirokazu
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.03.2017
• Subjects: Administration, Oral; Adolescent; Anticonvulsants - administration & dosage; Anticonvulsants - therapeutic use; Child; Child, Preschool; Drug Resistant Epilepsy - drug therapy; Drug Therapy, Combination - methods; Drug Tolerance; Epilepsy - drug therapy; Female; Humans; Intellectual disability; Levetiracetam; Male; MRI lesion; Neurology; Piracetam - administration & dosage; Piracetam - analogs & derivatives; Piracetam - therapeutic use; Refractory epilepsy; Retrospective Studies; Treatment Outcome; Refractory epilepsy; MRI lesion; Intellectual disability; Levetiracetam
• ISSN: 0387-7604; 1872-7131
• DOI: 10.1016/j.braindev.2016.09.008

Abstract Introduction Levetiracetam has a high tolerability and is effective against various seizure types and epilepsy syndromes. However, no study has specifically evaluated the efficacy of levetiracetam in children with refractory epilepsy based on magnetic resonance imaging (MRI) findings and the presence of intellectual disability (ID). Methods We retrospectively evaluated levetiracetam efficacy and safety in 49 pediatric patients who met the following inclusion criteria: (1) diagnosis of refractory epilepsy with first-line antiepileptic (AED) treatment ⩾2 years, (2) younger than 20 years old, and (3) received oral levetiracetam treatment for ⩾6 months. We assessed the relationships of these outcomes with MRI findings and ID status. Results Eighteen (37%) patients achieved a ⩾50% reduction in seizure frequency, and the majority (78%) had no remarkable side effects. Twenty-two (45%) patients had previously been treated with more than seven antiepileptic drugs prior to levetiracetam. Among 18 patients who achieved a ⩾50% reduction in seizure frequency, 13 and 5 had negative and positive MRI findings, and 9 and 9 had and did not have ID, respectively. Conclusions Our findings suggest that even for intractable pediatric cases with symptomatic etiology (i.e., MRI lesion and ID), levetiracetam has favorable efficacy for refractory epilepsy with tolerable adverse effects.