Abstracts

RATIONALE: Levetiracetam (Keppra) has recently been introduced onto the UK/US market for the treatment of drug resistant localisation related (partial onset) epilepsy. Its pre-clinical profile would strongly suggest that it might be effective in primary generalised epilepsy particularly Juvenile Myoclonic Epilepsy (JME) because it is related to piracetam, used in resistant myoclonias. We have therefore been trying levetiracetam in our clinic population of patients with JME resistant to conventional treatment (valproate and/or lamotrigine).
METHODS: The notes of all patients in our clinic with resistant JME who had been prescribed levetiracetam (either in previous clinical trials with subsequent open prescriptions or with the marketed drug) were reviewed for evidence of efficacy, side effects and drug withdrawal.
RESULTS: Over 30 patients have been assessed and have taken it for long enough for efficacy to be evaluated. 62% became, and currently remain, seizure free. Only 2 have so far failed to show any response. Early morning myoclonic jerks, often so difficult to completely control with other medication, seem to respond particularly well.
CONCLUSIONS: Levetiracetam shows early promise in resistant JME. Formal trials of its efficacy in this condition against placebo should be undertaken.
NOTE
Prescription of marketed levetiracetam for this purpose is outwith the current licence and was prescribed with full medical responsibility being taken by the medically qualified author (TB).
Disclosure: Grant - Our department has received research funding from UCB Pharma for clinical trials, but not for this study. Consulting - TB is on the UK UCB Pharma advisory board. Honoraria - TB has received occasional honoraria for speaking for UCB Pharma.