Evaluation of efficacy and tolerability of levetiracetam as an add-on therapy in intractable epilepsy of children

One-third of epilepsy of children is refractory and this study was conducted to evaluate efficacy and adverse events of levetiracetam as an add-on therapy in treatment of refractory epilepsy of children.

In a quasi- experimental study, seizures frequency and side effects of 314 children aged 1-14 years with refractory epilepsy who were referred to Pediatric Neurology Clinic of Shahid Sadoughi Medical Sciences University, Yazd, Iran and treated with levetiracetam for six months, were evaluated.

142 girls and 172 boys with mean age of 6.78±2.12 years were evaluated. At the end of six months of treatment with levetiracetam, 20% became seizure free, 28% had more than 50% decrease in seizure frequency, 38% did not have a notable change in seizure frequency and 14% experienced an increase in seizure frequency. Good response (stopping of all seizures or more than 50% reduction in seizure frequency) was seen in 51% of mixed type, 61% of myoclonic seizures, 64% of generalized tonic clonic seizures, 69 % of partial seizures, 100 % of tonic seizures and in 40 % of atonic seizures. Levetiracetam was significantly more effective in partial seizures, idiopathic epilepsies, children with normal developmental status and normal brain MRI. Twelve children discontinued the treatment due to severe drowsiness, restlessness and exacerbation of seizures. Transient and mild side effects were seen in 9%(N=28) including somnolence, anorexia, fatigue, headache, ataxia and diplopia.

Levetiracetam could be considered as an efficient and safe adjunct therapy in treatment of refractory epilepsy in children.