Levetiracetam during 1-year follow-up in children, adolescents, and young adults with refractory epilepsy.
OBJECTIVE
To evaluate the efficacy and safety of levetiracetam (LEV) in refractory crypto/symptomatic, partial or generalised epilepsy in children, adolescents and young adults.


METHODS
We performed a prospective open label add-on study in 99 patients (age 12 months to 32 years, mean 14 years) with partial or generalised, crypto/symptomatic seizures. Levetiracetam was added to no more than two baseline AEDs and the efficacy was rated according to seizure type and frequency.


RESULTS
LEV was initiated at the starting dose of 10mg/kg/day with 5-day increments up to 50 mg/kg/day, unless it was not tolerated. Concomitant therapy was generally not modified throughout the study. After a mean follow-up period of 6.7 months (range 3 weeks to 29 months), 11 patients (11.1%) were free of seizures (cryptogenic partial epilepsy, 5; symptomatic partial epilepsy, 6). A more than 75% seizure decrease was found in 14 patients (14.1%) and >50% in 8 (8.1%). Seizures were unchanged in 38 (38.4%), and worsened in 23 (23.2%). Mild and transient adverse side effects were found in 17 patients (17.2%), mostly represented by irritability and drowsiness.


CONCLUSIONS
LEV appears to be well tolerated in children and adolescents with severe epilepsy and seems to be a broad spectrum AED, though in our experience, it was more effective against partial seizures with or without secondarily generalisation. LEV efficacy in other epilepsy syndrome should be evaluated further in homogeneous, more selected patients.
Coppola
Giangennaro
G
Clinic of Child and Adolescent Neuropsychiatry, Second University of Naples, Naples, Italy.
Mangano
Salvatore
S
Tortorella
Gaetano
G
Pelliccia
Andrea
A
Fels
Antonio
A
Romano
Angela
A
Nardello
Rosaria
R
Habetswallner
Francesco
F
Licciardi
Felicia
F
Operto
Francesca Felicia
FF
Pascotto
Antonio
A
D000293:Adolescent; D000328:Adult; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D004827:Epilepsy / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D000077287:Levetiracetam; D008297:Male; D010889:Piracetam / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use*; D011446:Prospective Studies; D018709:Statistics, Nonparametric
D000077287:Levetiracetam; D010889:Piracetam