Levetiracetam for the treatment of idiopathic generalized epilepsy with myoclonic seizures.
BACKGROUND
Currently, there are no published randomized controlled trials evaluating the efficacy and safety of adjunctive antiepileptic therapy in idiopathic generalized epilepsy with myoclonic seizures.


METHODS
This randomized, double-blind, placebo-controlled multicenter trial assessed the efficacy and tolerability of adjunctive treatment with levetiracetam 3,000 mg/day in adolescents (>or=12 years) and adults (<or=65 years) with idiopathic generalized epilepsy, who experienced myoclonic seizures on >or=8 days during a prospective 8-week baseline period, despite antiepileptic monotherapy. The 8-week baseline period was followed by 4-week up-titration, 12-week evaluation, and 6-week down-titration/conversion periods.


RESULTS
Of 122 patients randomized, 120 (levetiracetam, n = 60; placebo, n = 60) were evaluable. Diagnoses were either juvenile myoclonic epilepsy (93.4%) or juvenile absence epilepsy (6.6%). A reduction of >or=50% in the number of days/week with myoclonic seizures was seen in 58.3% of patients in the levetiracetam group and in 23.3% of patients in the placebo group (p < 0.001) during the treatment period. Levetiracetam-treated patients were more likely to respond to treatment than patients receiving placebo (OR = 4.77; 95% CI, 2.12 to 10.77; p < 0.001). Levetiracetam-treated patients had higher freedom from myoclonic seizures (25.0% vs 5.0%; p = 0.004) and all seizure types (21.7% vs 1.7%; p < 0.001) during the evaluation period. The only adverse events more frequent with levetiracetam were somnolence and neck pain.


CONCLUSIONS
These results suggest that levetiracetam is an effective and well-tolerated adjunctive treatment for patients with previously uncontrolled idiopathic generalized epilepsy with myoclonic seizures.
Noachtar
S
S
Epilepsy Centre, Department of Neurology, University of Munich, Marchioninistr. 15, 81377 Munich, Germany. noa@med.uni-muenchen.de
Andermann
E
E
Meyvisch
P
P
Andermann
F
F
Gough
W B
WB
Schiemann-Delgado
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D002648:Child; D004311:Double-Blind Method; D004831:Epilepsies, Myoclonic / Q000150:complications / Q000188:drug therapy*; D004829:Epilepsy, Generalized / Q000150:complications / Q000188:drug therapy*; D005069:Evaluation Studies as Topic; D006801:Humans; D000077287:Levetiracetam; D008875:Middle Aged; D010889:Piracetam / Q000031:analogs & derivatives* / Q000627:therapeutic use; D012189:Retrospective Studies; D012720:Severity of Illness Index
D000927:Anticonvulsants; D000077287:Levetiracetam; D010889:Piracetam