Levetiracetam in the prophylaxis of migraine with aura: a 6-month open-label study.
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.
Brighina
Filippo
F
Neurophysiology Unit, Department of Neurology, University of Palermo, Palermo, Italy.
Palermo
Antonio
A
Aloisio
Antonina
A
Francolini
Margherita
M
Giglia
Giuseppe
G
Fierro
Brigida
B
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
D000927:Anticonvulsants; D000077287:Levetiracetam; D010889:Piracetam