title: [Efficacy and safety of levetiracetam (keppra) add-on treatment in adult patients with refractory epilepsy in two tertiary centers].
abstract: BACKGROUND
  Levetiracetam (LEV) is a new generation anti-epileptic drug, which has been approved as add-on therapy for partial epilepsy. The mechanism of LEV is not yet completely understood.
  
  
  OBJECTIVE
  To evaluate the efficacy and tolerability of LEV in adult patients with refractory epilepsy.
  
  
  METHODS
  We report the results of 49 patients with refractory epilepsy, with partial and generalized seizures, who received LEV as an add-on treatment, in two tertiary medical centers. There were 27 males, mean age 35.4+13 years. The average duration of epilepsy was 21 + 11 years, the average seizure rate was 31 + 30 per month. The patients were treated with a mean of 2.6 AED when LEV was introduced. The patients were treated for 12.6 + 9.7 months with an average dose of 1964 + 743.7 mg LEV per day.
  
  
  RESULTS
  Five (10%) patients became seizure free, 12 (25%) responded with seizure reduction of more than 50% following the introduction of LEV, 8 (16%) responded with seizure reduction of less than 50%, no response to LEV was reported in 20 (41%) and seizure aggravation occurred in 4 (8%). No serious persistent adverse events were reported. The main side effect was drowsiness in 10% of patients.
  
  
  CONCLUSIONS
  The results of this study, as well as previous studies, suggest that LEV is a well-tolerated new antiepileptic drug, and as an add-on therapy it may effectively improve seizure control in patients with intractable epilepsy.
authors.affiliation: EEG and Epilepsy Unit, Department of Neurology, Tel Aviv Sourasky Medical Center.
authors.forename: Eitan
authors.initials: E
authors.lastname: Auriel
authors.forename: Vladimir
authors.initials: V
authors.lastname: Chistik
authors.forename: Ilan
authors.initials: I
authors.lastname: Blatt
authors.forename: Nahum
authors.initials: N
authors.lastname: Margolin
authors.forename: Miri
authors.initials: M
authors.lastname: Neufeld
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use*; D004827:Epilepsy / Q000188:drug therapy*; D005260:Female; D006801:Humans; D000077287:Levetiracetam; D008297:Male; D008875:Middle Aged; D010889:Piracetam / Q000031:analogs & derivatives* / Q000627:therapeutic use; D012640:Seizures / Q000503:physiopathology / Q000517:prevention & control; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants; D000077287:Levetiracetam; D010889:Piracetam