title: Effectiveness of levetiracetam use following resective surgery in patients with refractory epilepsy: a prospective observational study.
abstract: OBJECTIVE
  This study aimed to evaluate the effectiveness of levetiracetam (LEV) use for seizure control in patients who had undergone resective surgery for intractable epilepsy in routine clinical practice.
  
  
  METHODS
  This was a prospective, observational study. Refractory epilepsy patients who underwent epilepsy surgery from January 2008 to December 2011 in the Department of Neurosurgery, West China Hospital were prospectively analyzed. Patients were divided into two groups according to antiepileptic drug (AED) treatment used immediately after epilepsy surgery (group A: therapy with LEV; group B: therapy without LEV). AED regimens were compared with regard to seizure-outcome for a period of more than 2 years. The International League Against Epilepsy (ILAE) classification was used to categorize seizure outcome.
  
  
  RESULTS
  A total of 319 patients (184 male and 135 female patients; mean age 28.2±13.4 years) were studied. The mean postoperative follow-up period was 3.9±1.2 years. The two groups showed was no significant difference in preoperative baseline data. At the 6-month follow-up, the proportion of patients with seizure freedom was significantly higher in group A than in group B (78.8% vs. 67.5%, p=0.03). Seizure outcomes after 2 years were assessed using the ILAE classification. The proportion of patients under ILAE seizure-outcome classification I (seizure freedom) was significantly higher in group A than in group B (74.3% vs. 60.7%, p=0.01). Seizure recurrence rates at the final assessment, after planned reduction or withdrawal, were 26.3% for group A and 40.6% for group B (p=0.04).
  
  
  CONCLUSIONS
  AED strategy after resective surgery may be a potentially modifiable prognostic indicator influencing seizure outcome in patients with intractable epilepsy. Compared to other AEDs, LEV appears to be more effective in controlling postoperative seizures in our long-term follow-up, and the advantage can be seen in early stage after surgery.
authors.affiliation: Department of Neurology, West China Hospital of Sichuan University; Department of Neurology, Chengdu second people's hospital.
authors.forename: Tian-fang
authors.initials: TF
authors.lastname: Zeng
authors.affiliation: Department of Neurology, West China Hospital of Sichuan University.
authors.forename: Yao-hua
authors.initials: YH
authors.lastname: Li
authors.affiliation: Department of Neurology, West China Hospital of Sichuan University.
authors.forename: Dong-mei
authors.initials: DM
authors.lastname: An
authors.affiliation: Department of Neurology, West China Hospital of Sichuan University.
authors.forename: Lei
authors.initials: L
authors.lastname: Chen
authors.affiliation: Department of Neurosurgery, West China Hospital of Sichuan University.
authors.forename: Ding
authors.initials: D
authors.lastname: Lei
authors.affiliation: Department of Neurology, Chengdu second people's hospital.
authors.forename: Bei
authors.initials: B
authors.lastname: Zhang
authors.affiliation: Department of Neurology, West China Hospital of Sichuan University. Electronic address: jinmeili-neuro@qq.com.
authors.forename: Jin-mei
authors.initials: JM
authors.lastname: Li
authors.affiliation: Department of Neurology, West China Hospital of Sichuan University. Electronic address: zhoudong66@yahoo.de.
authors.forename: Dong
authors.initials: D
authors.lastname: Zhou
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000627:therapeutic use*; D001921:Brain / Q000187:drug effects / Q000503:physiopathology / Q000601:surgery; D002648:Child; D004827:Epilepsy / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000077287:Levetiracetam; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D010889:Piracetam / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D000077287:Levetiracetam; D010889:Piracetam
keywords: Antiepileptic drug; Levetiracetam (LEV); Refractory epilepsy; Seizure recurrence; Surgery