Abstracts

RATIONALE: Levetiracetam is a newly approved drug for adjunctive treatment of partial epilepsy. This study serves to establish the usefulness of levetiracetam in an academic referral center with patients categorized by age and seizure type.
METHODS: We retrospectively reviewed the records of 31 patients with intractable epilepsy treated with levetiracetam at Stony Brook University Hospital[ssquote]s Epilepsy Management Program between 4/25/2000 and 4/24/2001 with respect to efficacy, duration of treatment, and adverse events.
RESULTS: The study included 3 children ([lt] 16 years old, age range 6-11) and 28 adults ([gt] 16 years old, age range 17-88). Every patient was taking at least one other AED, and 12 had a vagal nerve stimulator implanted at the time levetiracetam was started. All three children had primary generalized tonic-clonic seizures and efficacy was seen in 0/3. Among the adults, reduction of seizure frequency of [gt] 50% was found in 10/24 (41.7%) of the patients with partial (simple, complex, and/or secondarily generalized) seizures and 3/4 (75%) with primary generalized seizures. Furthermore, three of the patients remained seizure free for the duration of the study and two others had auras only without any generalization. Levetiracetam was discontinued in 14 patients (45%), seven due to lack of efficacy and seven due to side effects. The most commonly reported side effect was lethargy (n=6, 19.3%) but only one of these patients (3.2%) discontinued for this reason. Individual patients described psychosis, cerebellar symptoms, night terrors, urinary incontinence, and rash, each of which (except the incontinence) caused discontinuation of the drug. Mean duration of treatment, with or without discontinuation of medication, as of 4/24/01, was 5.5 months.
CONCLUSIONS: Our study confirms the initial studies of levetiracetam in terms of efficacy for adults with partial seizures and of side effects. It also indicates that levetiracetam may be even more useful as adjunctive therapy for adults with primary generalized seizures. However, the sample size was quite small and further double blind, randomized studies are needed to establish this indication. The sample size was too small to evaluate levetiracetam[ssquote]s usefulness in children.