Affiliations: Department of Medical Services, Cipla Limited, Mumbai, India
Note: [] Correspondence: Dr. Zarrin A. H. Ansari, Medical Services
Department, Cipla Limited, 289, Bellasis Rd, Mumbai Central, Mumbai-400008,
Maharashtra, India. Tel.: +91 9833988420, +91 22 2302 5754; Fax: +91 22 2307
0013, +91 22 2307 0393; E-mail: zarrin.ansari@cipla.com, zarrinansari@gmail.com
Abstract: Age-specific distribution of epilepsy is bimodal, with the highest
incidence being in childhood. Seizures can affect life as early as day one.
There is a paramount variation of epilepsy in childhood and adolesence with
regards to its etiology and prognosis. Antiepileptic drugs, being the mainstay
of treatment, necessitates that their use in this vulnerable age group must be
made after a thorough look into the available evidence. The data on
levetiracetam (LEV), a second-generation antiepileptic, spans from randomized
controlled trials to case reports in various pediatric epilepsy and epileptic
syndromes. This review is a compilation and critical analysis of the data on
the differences in the pharmacokinetic properties of LEV in children versus
adults, drug-interactions, efficacy of LEV in various contexts, namely, as
add-on, as monotherapy, in partial and generalized seizures, in specific
epilepsy syndromes such as benign epilepsy with centrotemporal spikes,
epileptic syndromes with continuous spike and wave during sleep, Lennox-Gastaut
syndrome, Jeavons syndrome and epilepsy associated with tuberous sclerosis. LEV
is an effective option for the treatment of partial-onset seizures as both an
add-on in refractory epilepsy and monotherapy in newly diagnosed focal
epilepsies. There are preliminary but promising data available on various
epileptic syndromes and epileptic encephalopathies that can nudge researchers
towards further work in these areas in order to generate evidences that is more
substantial. The safety and tolerability profile of LEV is favorable, though,
behavioral and neuropsychiatric adverse events are reportedly higher in
children versus adults. The neuropsychiatric adverse events are often observed
against the background of previously existing behavioral issues and
neurocognitive impairments.
