LEVETIRACETAM ([italic]KEPPRA[/italic]) IN CHILDREN WITH INTRACTABLE EPILEPSY. A MULTI-CENTRE CLINICAL AUDIT
Abstract number :
2.393
Submission category :
Year :
2004
Submission ID :
4842
Source :
www.aesnet.org
Presentation date :
12/2/2004 12:00:00 AM
Published date :
Dec 1, 2004, 06:00 AM
Authors :
1Santosh R. Mordekar, 2Jay Gosalakkal, 3Dierdre Peake, 1Richard Neal, 4Christopher D. Rittey, 3Sunny G. Philip, and 5William P. Whitehouse
Levetiracetam (LEV) is licensed for treatment of focal seizures in adults and has been reported to be effective in childhood epilepsy. We describe our experience of LEV in children with intractable epilepsy in the Midlands, UK. Children prescribed LEV from 2001 to 2003 were systematically ascertained from the pharmacy records and departmental databases of 4 tertiary pediatric neurology centers. A retrospective chart review of patients using a standard proforma to assess seizure type, seizure frequency, prior and concomitant anti-epileptic drugs (AEDs) and adverse events was undertaken. So far data on 132 children (76 males) aged 1 [ndash] 18 years (mean 9 years 2 months), and 104.5 person years of exposure, has been collected. Mean age of onset of epilepsy was 3.4 years (2 days [ndash] 14.9 years). Sixty five (49%) had focal seizures, 61 (47%) had generalised seizures and 6 (4%) had mixed seizure types. Forty seven (36%) children had received more than 5 AEDs, 43 (32%) 4 AEDs, 22 (17%) 3 AEDs, and 20 (15%) 2 AEDs prior to LEV. LEV dose ranged from 10 [ndash] 100 mg/kg/day. Follow up ranged from 6 [ndash] 28 months, duration of treatment ranged from 1 [ndash] 28 months (mean 9.5 months). Fourteen (11%) achieved LEV monotherapy.
More than 50% reduction in seizure frequency was obtained in 37 (57%) with focal seizures, 30 (49%) with generalised seizures and 2 (33%) with mixed seizure types. Seizure freedom for 6 months or more was achieved in 7 (11%) with focal epilepsy, 5 (8%) with generalised epilepsy and 1 (16%) with mixed seizure types. 20 (31%) with focal seizures, 24 (39%) with generalised seizures and 3 (50%) with mixed seizure types showed no improvement. 8 (12%) with focal seizures and 7 (11%) with generalised seizures had increased seizures.
21 (16%) children reported adverse events leading to withdrawal in 17 (13%). There were no serious adverse events. LEV appears to be effective and well tolerated in a variety of intractable childhood epilepsies. We aim to have 12 month follow-up data on 150 children by the end of 2004.