title: Levetiracetam for the treatment of idiopathic generalized epilepsy with myoclonic seizures.
abstract: 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.
authors.affiliation: Epilepsy Centre, Department of Neurology, University of Munich, Marchioninistr. 15, 81377 Munich, Germany. noa@med.uni-muenchen.de
authors.forename: S
authors.initials: S
authors.lastname: Noachtar
authors.forename: E
authors.initials: E
authors.lastname: Andermann
authors.forename: P
authors.initials: P
authors.lastname: Meyvisch
authors.forename: F
authors.initials: F
authors.lastname: Andermann
authors.forename: W B
authors.initials: WB
authors.lastname: Gough
authors.forename: J
authors.initials: J
authors.lastname: Schiemann-Delgado
mesh_terms: 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
chemical_list: D000927:Anticonvulsants; D000077287:Levetiracetam; D010889:Piracetam