title: Levetiracetam in the prophylaxis of migraine with aura: a 6-month open-label study.
abstract: OBJECTIVE
  To evaluate the efficacy of levetiracetam as prophylactic treatment for migraine with aura with high frequency of attacks.
  
  
  BACKGROUND
  Migraine with aura with high frequency of attacks could represent a very demanding therapeutic problem. Efficacy of the antiepileptic drug, lamotrigine, has been reported in this form of migraine. Levetiracetam is a new antiepileptic drug with an excellent tolerability profile. Mechanisms of action of this drug remain largely unknown, but recently, it has been shown to exert inhibitory effects on neuronal-type calcium channels.
  
  
  METHODS
  We performed a small open-label trial treating 16 patients affected by migraine with aura with high frequency of attacks. After a 1-month run-in period, patients were treated with levetiracetam at a dosage of 1000 mg/d for 6 months.
  
  
  RESULTS
  The number of attacks per month was significantly reduced during the first month (compared with run-in; P < 0.001), and it was reduced further during the second (second month vs first month; P < 0.001) and the third months (third month vs second month; P < 0.001) of the treatment. This improvement persisted unchanged for the remaining 3 months of treatment. In 7 (44%) of the 16 patients, the attacks were completely abolished after 3 months of treatment. Severity of headache and duration of headache and aura were also significantly reduced at the third and sixth months of treatment (P < 0.001). Levetiracetam was well tolerated (6 patients complained of slight dizziness, nervousness, and somnolence).
  
  
  CONCLUSIONS
  Levetiracetam seems to be a safe and effective treatment for migraine with aura. Controlled trials are needed to confirm the observed results.
authors.affiliation: Neurophysiology Unit, Department of Neurology, University of Palermo, Palermo, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Brighina
authors.forename: Antonio
authors.initials: A
authors.lastname: Palermo
authors.forename: Antonina
authors.initials: A
authors.lastname: Aloisio
authors.forename: Margherita
authors.initials: M
authors.lastname: Francolini
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Giglia
authors.forename: Brigida
authors.initials: B
authors.lastname: Fierro
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D000077287:Levetiracetam; D008297:Male; D008875:Middle Aged; D020325:Migraine with Aura / Q000517:prevention & control*; D010889:Piracetam / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011446:Prospective Studies
chemical_list: D000927:Anticonvulsants; D000077287:Levetiracetam; D010889:Piracetam