title: Efficacy and tolerability of levetiracetam for pediatric refractory epilepsy.
abstract: BACKGROUND
  Levetiracetam has a high tolerability and is effective against various seizure types and epilepsy syndromes. However, no study has specifically evaluated the efficacy of levetiracetam in children with refractory epilepsy based on magnetic resonance imaging (MRI) findings and the presence of intellectual disability (ID).
  
  
  METHODS
  We retrospectively evaluated levetiracetam efficacy and safety in 49 pediatric patients who met the following inclusion criteria: (1) diagnosis of refractory epilepsy with first-line antiepileptic (AED) treatment ⩾2years, (2) younger than 20years old, and (3) received oral levetiracetam treatment for ⩾6months. We assessed the relationships of these outcomes with MRI findings and ID status.
  
  
  RESULTS
  Eighteen (37%) patients achieved a ⩾50% reduction in seizure frequency, and the majority (78%) had no remarkable side effects. Twenty-two (45%) patients had previously been treated with more than seven antiepileptic drugs prior to levetiracetam. Among 18 patients who achieved a ⩾50% reduction in seizure frequency, 13 and 5 had negative and positive MRI findings, and 9 and 9 had and did not have ID, respectively.
  
  
  CONCLUSIONS
  Our findings suggest that even for intractable pediatric cases with symptomatic etiology (i.e., MRI lesion and ID), levetiracetam has favorable efficacy for refractory epilepsy with tolerable adverse effects.
authors.affiliation: Department of Pediatrics, Gunma University Graduate School of Medicine, Gunma, Japan; Department of Pediatrics, Maebashi Red Cross Hospital, Gunma, Japan. Electronic address: kaz-mura@gunma-u.ac.jp.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Muramatsu
authors.affiliation: Department of Pediatrics, Gunma University Graduate School of Medicine, Gunma, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Sawaura
authors.affiliation: Department of Pediatrics, Gunma University Graduate School of Medicine, Gunma, Japan.
authors.forename: Tomomi
authors.initials: T
authors.lastname: Ogata
authors.affiliation: Department of Pediatrics, Gunma University Graduate School of Medicine, Gunma, Japan.
authors.forename: Nishiki
authors.initials: N
authors.lastname: Makioka
authors.affiliation: Department of Pediatrics, Gunma University Graduate School of Medicine, Gunma, Japan; Department of Pediatrics, JCHO Gunma Chuo Hospital, Gunma, Japan.
authors.forename: Keiko
authors.initials: K
authors.lastname: Tomita
authors.affiliation: Department of Pediatrics, Gunma University Graduate School of Medicine, Gunma, Japan; Department of Pediatrics, Motojima General Hospital, Gunma, Japan.
authors.forename: Toshino
authors.initials: T
authors.lastname: Motojima
authors.affiliation: Department of Pediatrics, Gunma University Graduate School of Medicine, Gunma, Japan; Department of Pediatrics, Isesaki Municipal Hospital, Gunma, Japan.
authors.forename: Kuniko
authors.initials: K
authors.lastname: Ida
authors.affiliation: Department of Pediatrics, Gunma University Graduate School of Medicine, Gunma, Japan.
authors.forename: Kyoko
authors.initials: K
authors.lastname: Hazama
authors.affiliation: Department of Pediatrics, Gunma University Graduate School of Medicine, Gunma, Japan.
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Arakawa
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000927:Anticonvulsants / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D000069279:Drug Resistant Epilepsy / Q000188:drug therapy*; D004359:Drug Therapy, Combination / Q000379:methods; D004361:Drug Tolerance; D004827:Epilepsy / Q000188:drug therapy*; D005260:Female; D006801:Humans; D000077287:Levetiracetam; D008297:Male; D010889:Piracetam / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants; D000077287:Levetiracetam; D010889:Piracetam
keywords: Intellectual disability; Levetiracetam; MRI lesion; Refractory epilepsy