Affiliations: Department of Neurosciences, King Faisal Specialist
Hospital and Research Centre, Jeddah, Saudi Arabia | Department of Pediatrics, King Abdulaziz University
Hospital, Jeddah, Saudi Arabia
Note: [] Correspondence: Dr. Mohammed M.S. Jan, Associate Professor and
Consultant of Pediatric Neurology, King Abdulaziz University Hospital, P O Box
80215, Jeddah 21589, Kingdom of Saudi Arabia. Tel.: +996 2 6401000 (ext.
20208); Fax: +996 2 6403975; E-mail: mmsjan@yahoo.com
Abstract: Levetiracetam (LEV) is a new antiepileptic drug (AED), which has a
mechanism of action distinct from that of other AEDs suggesting a potentially
valuable therapeutic profile. Our objective is to report our experience in
treating children with intractable epilepsy. Prospective, open label, add on
trial of LEV in treating consecutive children with intractable epilepsy
(defined as recurrent seizures after at least three antiepileptic medication
trials). Follow up by one pediatric neurologist was performed. Therapeutic
response was recorded as complete (no seizures), good (> 50% seizure
reduction), fair (< 50% seizure reduction), or none. Thirty children
(58% males) aged 15 months-15 years (mean 5.8 years, SD 3.9) were included.
Most children (80%) had daily seizures, were tried on multiple AEDs (mean 4.7,
SD 1.5), and had cognitive deficits (86%). The epilepsy was symptomatic in
64%. The mean LEV dose was 41 mg/kg/day and the children were followed for
4–8 months (median 5 months, SD 2.5). After the introduction of LEV, six
(20%) children became completely seizure free and 43% had > 50% seizure
reduction. The percentage of children with daily seizure was reduced from 80%
before LEV to 27% afterward (P<0.0001). Side effects were reported in
10 (33%) children in the form of decreased appetite, irritability, sedation,
and seizure worsening. The majority were transient, however, LEV had to be
withdrawn in four (13%) children because of lack of efficacy or seizure
worsening. LEV is a novel AED with a broad spectrum of antiepileptic efficacy.
The drug was well tolerated and most side effects were transient. However,
larger controlled studies are needed in young children to establish the
long-term efficacy and safety.
