title: Efficacy and safety of IV levetiracetam in children with acute repetitive seizures.
abstract: BACKGROUND
  Levetiracetam has been proven to be effective in both partial and generalized seizures in children. However, few studies have reported its efficacy in the treatment of acute repetitive seizures. We aimed to investigate the efficacy and safety of levetiracetam in children with acute repetitive seizures.
  
  
  METHODS
  The medical records of children from the age of 1 month-18 years who received levetiracetam because of acute repetitive seizures in the pediatric intensive care unit between 2010 and 2013 were reviewed retrospectively.
  
  
  RESULTS
  Of the 133 patients, levetiracetam terminated seizures in 104 (78.2%). Side effects such as agitation and aggression were observed in three patients (2.2%). The likelihood of treatment failure was increased by four times by younger age at seizure onset; by six times in the individuals with neurological abnormalities; and by 22 times in the patients with West syndrome. The patients who used levetiracetam as the first treatment option for acute repetitive seizures had a longer duration of epilepsy, a higher rate of neurological abnormality, and a higher proportion of medically resistant epilepsy compared with the individuals who used levetiracetam as an add-on treatment to the other intravenous antiepileptic drugs. However, no differences were detected between these two groups in terms of treatment response.
  
  
  CONCLUSIONS
  Intravenous levetiracetam appears to be effective and safe in the treatment of acute repetitive seizures. Randomized clinical trials are needed to determine whether intravenous levetiracetam may replace other antiepileptic drugs as the first-line therapy in the management of acute repetitive seizures.
authors.affiliation: Department of Pediatric Intensive Care Unit, Dr. Behçet Uz Children's Hospital, Izmir, Turkey. Electronic address: dr.ranaisguder@yahoo.com.
authors.forename: Rana
authors.initials: R
authors.lastname: İşgüder
authors.affiliation: Department of Pediatric Neurology, Dr. Behçet Uz Children's Hospital, Izmir, Turkey.
authors.forename: Orkide
authors.initials: O
authors.lastname: Güzel
authors.affiliation: Department of Pediatric Intensive Care Unit, Dr. Behçet Uz Children's Hospital, Izmir, Turkey.
authors.forename: Hasan
authors.initials: H
authors.lastname: Ağın
authors.affiliation: Department of Pediatric Neurology, Dr. Behçet Uz Children's Hospital, Izmir, Turkey.
authors.forename: Ünsal
authors.initials: Ü
authors.lastname: Yılmaz
authors.affiliation: Department of Pediatric Intensive Care Unit, Dr. Behçet Uz Children's Hospital, Izmir, Turkey.
authors.forename: Sanem Eren
authors.initials: SE
authors.lastname: Akarcan
authors.affiliation: Department of Pediatric Intensive Care Unit, Dr. Behçet Uz Children's Hospital, Izmir, Turkey.
authors.forename: Tanju
authors.initials: T
authors.lastname: Celik
authors.affiliation: Department of Pediatric Neurology, Dr. Behçet Uz Children's Hospital, Izmir, Turkey.
authors.forename: Aycan
authors.initials: A
authors.lastname: Ünalp
mesh_terms: D000293:Adolescent; D000927:Anticonvulsants / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007275:Injections, Intravenous; D000077287:Levetiracetam; D008279:Magnetic Resonance Imaging; D008297:Male; D010889:Piracetam / Q000008:administration & dosage / Q000031:analogs & derivatives*; D012372:ROC Curve; D012189:Retrospective Studies; D012640:Seizures / Q000145:classification / Q000188:drug therapy*; D018709:Statistics, Nonparametric
chemical_list: D000927:Anticonvulsants; D000077287:Levetiracetam; D010889:Piracetam
keywords: acute repetitive seizures; antiepileptic drugs; children; levetiracetam