CLINICAL EXPERIENCE WITH LEVETIRACETAM IN INTRACTABLE EPILEPSY
Abstract number :
1.279
Submission category :
Year :
2003
Submission ID :
4002
Source :
www.aesnet.org
Presentation date :
12/6/2003 12:00:00 AM
Published date :
Dec 1, 2003, 06:00 AM
Authors :
James D. Bruno, Deborah A. Galloway, Hasan M. Mousli, Mary R. Andriola Neurology, State University of New York at Stony Brook, Stony Brook, NY
Levetiracetam (LEV) is an antiepileptic drug (AED) approved as adjunctive therapy in the treatment of partial onset seizures in adults with epilepsy. The purpose of this study was to review our clinical experience with LEV in the various epilepsies in adults and children referred to an academic center.
Adult patients with intractable epilepsy despite adequate exposure to other AED(s) were started on LEV 500mg BID and titrated up to 3gm per day. The children were started on LEV 250mg BID and titrated up to 1.5 gm per day. These patients were followed for efficacy ([ge]50% seizure reduction) and adverse events (AEs) from April 2000 until April 2003. Mean duration of treatment at the last clinic visit was 12.2 months.
24 patients who range in age from 6 to 88 years were entered into the study. Seizures were classified as intractable primary generalized (N=2) or partial onset (N=21). One patient had Lennox-Gastaut syndrome. Associated conditions included schizencephaly, stroke, cerebral palsy, and astrocytoma. Six patients had Vagal Nerve Stimulators. All patients were on one to three AEDS when LEV was added. Efficacy of [ge] 50% seizure control was reported in eight (33%) of the twenty-four patients using LEV as adjunctive therapy to one two or three other AED(s). Of those patients showing improvement, one had generalized epilepsy and seven had partial onset epilepsy. One patient with partial onset achieved 100% seizure control. No patients demonstrated worsening of their seizures while on LEV. No patients with VNS showed benefits from LEV.
Eleven patients discontinued the drug due to lack of efficacy. Five patients discontinued the drug due to AEs. One child experienced night terrors. Three patients reported confusion and agitation. One patient reported rash. Six patients reported symptoms of lethargy.
Levetiracetam was well tolerated in the majority of patients (58 %) in this varied population of adults and children with intractable generalized and partial onset epilepsy. Approximately eight (33.3%) of the twenty-four patients had had significant decrease in seizure severity and frequency. The most commonly reported adverse events were lethargy and confusion.