title: Clinical features of long-term low-dose levetiracetam treatment for epilepsy.
abstract: BACKGROUND
  The aim of this study was to assess the rate of response to long-term low-dose levetiracetam (LEV) treatment and the clinical factors associated with response.
  
  
  METHODS
  The response to low-dose LEV of 43 patients with epilepsy (22 male, 21 female; age range, 5-39 years; median age, 13 years) was retrospectively assessed. Patients aged <15 years received <20 mg/kg/day LEV, whereas those aged ≥15 years received <1000 mg/day LEV. Clinical features were compared between responders to low-dose LEV, responders to the recommended dose, and non-responders.
  
  
  RESULTS
  Of the 43 patients who received low-dose LEV, 13 (30%) showed improvement, defined as seizure cessation or >75% seizure reduction over 6 months for patients with monthly, weekly, and daily seizures; and over 1 year for patients with yearly seizures. Efficacy was maintained for >1 year in 10 (77%) of the 13 patients. Long-term response to low-dose LEV was significantly associated with older age at onset and fewer previous treatments with ineffective anti-epileptic drugs. All patients showing long-term response to low-dose LEV developed only focal seizures.
  
  
  CONCLUSIONS
  Titration of LEV starting from a low dose may be effective in selected patients. Once patients respond to low-dose treatment, maintenance of the effective dosage may prolong response.
authors.affiliation: Department of Pediatrics, Osaka Rosai Hospital, Osaka, Japan.
authors.forename: Sosuke
authors.initials: S
authors.lastname: Yoshikawa
authors.affiliation: Department of Pediatrics, Osaka Medical College, Osaka, Japan.
authors.forename: Shuichi
authors.initials: S
authors.lastname: Shimakawa
authors.affiliation: Department of Pediatrics, Osaka Medical College, Osaka, Japan.
authors.forename: Miho
authors.initials: M
authors.lastname: Fukui
authors.affiliation: Department of Pediatrics, Osaka Medical College, Osaka, Japan.
authors.forename: Shohei
authors.initials: S
authors.lastname: Nomura
authors.affiliation: Department of Pediatric Neurology, Tanabe Children's Clinic, Osaka, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Tanabe
authors.affiliation: Department of Pediatrics, Osaka Medical College, Osaka, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tamai
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004827:Epilepsy / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000077287:Levetiracetam; D008297:Male; D010889:Piracetam / Q000008:administration & dosage / Q000031:analogs & derivatives*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D000077287:Levetiracetam; D010889:Piracetam
keywords: epilepsy; levetiracetam; long-term treatment; low-dose treatment; titration