Levetiracetam as monotherapy or add-on drug in a large cohort of pediatric and young adult epilepsy patients

The aim of the present study was to evaluate the efficacy and tolerability of levetiracetam in a large series of children and young adults affected by partial or generalised epilepsy syndromes. Levetiracetam was titrated up to 50 mg/kg/24 hours, divided in 3 doses. Ninety-eight patients (52 males, 46 females), were retrospectively enrolled into the study. The age ranged between: 0-4 y, 11 (11.4%); 5-9 y, 27 (27.5%); 10-14 y, 22 (22.4%); 15-19 y, 22 (22.4%); > 19 y, 16 (16.3%). Diagnosis were: generalised epilepsy, 48 (epileptic encephalopathy, 24; idiopathic, 9; crypto-symptomatic, 15); partial epilepsy, 44 (idiopathic, 14; crypto-symptomatic, 30); undetermined, 6. Levetiracetam was given as first drug in 11 pts (11.2%), as add-on in 87 (88.8%) (+ 1 AED in 17; ≥ 2 AED in 70). Seizure frequency during baseline period was: daily, 50; weekly, 16; monthly, 25; sporadic, 7. After a follow-up period of 2 to 52 months (mean 17 months), a 100% seizure control was obtained in 12 pts (15.2%), a 50-98% seizure reduction in 38 (48.1%), a 25-50% in 9 (11.4%), unchanged in 20 (25.3%). Adverse side effects, alone or combined in the same patient, were recorded in 12 patients out of 98 (12.2%.). In conclusion, LEV appeared effective and well tolerated both in idiopathic and crypto/symptomatic generalised and partial epilepsy in pediatric patients.