Efficacy of levetiracetam in children with refractory epilepsy as an add-on trial

Background: Epilepsy is a common disease of childhood, in which almost 25% of cases are resistant to common antiepileptic drugs. Uncontrolled epilepsy increases morbidity and mortality rates, adversely affects growth and development in these children and imposes heavy psychological stress and financial burdens on parents, health care and society, making it mandatory to find effective therapies for the condition. Our aim was to study the efficacy of levetiracetam, as an add-on therapy, in children suffering from refractory epilepsy. Materials and methods: In this prospective add-on study, 45 children aged 0.6-15 years (median 5.9 years) with epilepsy not responding to most conventional or new antiepileptic drugs were treated by adding levetiracetam to their present antiepileptic regimen and followed for a minimum period of 12 weeks. The starting dose of 20 mg/kg/day was increased at intervals of 1 week by 10 mg/kg/day, if necessary, up to a maximum dose of 60 mg/kg/day. Results: Four children (8.7%) became seizure free, in 4 (8.7%), seizure frequency increased, and in 8 (17.4%) and 13 (28.3%) patients, seizure frequency decreased by 75-99% and 50-74% respectively. Overall levetiracetam was effective in 54.3% of patients, decreasing seizure frequency to at least 50% of baseline seizure frequency. Variables such as sex, age, duration of disease, type and cause of seizure, EEG and imaging data, also type of epileptic syndrome showed no statistically significant correlations with these results. Conclusion: Levetiracetam can be used as an effective add-on treatment in children with refractory epilepsy. (C) 2010 Elsevier B.V. All rights reserved.