Levetiracetam may be more effective for late-onset partial epilepsy.
BACKGROUND
Many agents are available for treating epilepsy; however, population studies have failed to show overall differences in efficacy for a given seizure type. Clinical experience suggests that certain individuals will respond to a given agent while others with the same seizure type will not.


OBJECTIVE
To examine a population of patients who received one of the newer antiepileptic drugs, levetiracetam, and to identify those who had either a dramatic improvement or a significant worsening of seizures.


METHODS
Retrospective medical record review of patients with refractory epilepsy.


RESULTS
Patients who responded well to levetiracetam therapy were older at the onset of epileptic seizure than those who did not (mean [SD] age, 51 [5] vs 27 [3] years; P<.05). This was also true of the subset of patients who had localization-related epilepsy. Patients with temporal lobe onset were likely to do well whereas patients with frontal lobe onset were not.


CONCLUSIONS
These results suggest that certain subpopulations may be particularly likely to respond to levetiracetam therapy. These need to be confirmed in a larger prospective trial; however, looking for specific characteristics of patients who respond to certain drugs may lead to useful guidelines for drug choices in treating epilepsy.
Bazil
Carl W
CW
Comprehensive Epilepsy Center, Department of Neurology, Columbia University, New York, NY 10032, USA. cwb11@columbia.edu
Rose
Andrew
A
Resor
Stanley
S
Yapicular
Bülent
B
Hirsch
Lawrence J
LJ
D000328:Adult; D017668:Age of Onset; D000927:Anticonvulsants / Q000627:therapeutic use*; D004828:Epilepsies, Partial / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D006801:Humans; D000077287:Levetiracetam; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D010889:Piracetam / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D011184:Postoperative Period; D011300:Preoperative Care / Q000706:statistics & numerical data; D012189:Retrospective Studies; D014706:Verbal Learning
D000927:Anticonvulsants; D000077287:Levetiracetam; D010889:Piracetam