A comparative study on the efficacy of levetiracetam and carbamazepine in the treatment of rolandic seizures in children: An open-label randomized controlled trial

Ahadi, Parisa; Nasiri, Jafar; Ghazavi, Mohammad Reza; Mosavian, Toktam; Mansouri, Vahid

doi:10.4103/jrpp.jrpp_20_53

Cited by 9 publications

(5 citation statements)

References 31 publications

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“…Other countries recommend levetiracetam, carbamazepine, sodium valporate, oxcarbazepine, and lamotrigine as first-line drugs (9). Similar to our findings, levetiracetam is more preferred due to its efficacy (in seizure control, EEG normalization, cognition, speech, and behavior) and less side effects (10)(11)(12)(13)(14). In this study, levetiracetam plus sodium valproate showed statistically significant association with reduction of SWI.…”

Section: Discussionsupporting

confidence: 88%

“…Several countries recommend the utilization of levetiracetam, carbamazepine, sodium valproate, oxcarbazepine, and lamotrigine as first-line drugs (9). Levetiracetam is more preferred due to its efficacy (in seizure control, EEG normalization, cognition, speech, and behavior) and less side effects (10)(11)(12)(13)(14). Moreover, as monotherapy, it has been shown to be effective even in other idiopathic generalized epilepsy, such as in the absence epilepsy and juvenile myoclonic epilepsy (15).…”

Section: Introductionmentioning

confidence: 99%

“…Early recognition of BECTS and mitigation of ESES with therapies that do not interfere with cognition might lower the rate of neuropsychological impairments. Currently, the available studies that investigated the efficacy of levetiracetam and sodium valproate on BECTS involved small sample sizes (11)(12)(13)(14)(18)(19)(20)(21)(22)(23)(24).…”

Section: Introductionmentioning

confidence: 99%

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Treatment for the Benign Childhood Epilepsy With Centrotemporal Spikes: A Monocentric Study

et al. 2021

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Background and Purpose: To date, there is no specific treatment guideline for the benign childhood epilepsy with centrotemporal spikes (BECTS). Several countries recommend levetiracetam, carbamazepine, sodium valproate, oxcarbazepine, and lamotrigine as first-line drugs. Nevertheless, some of these drugs are associated with cognitive decline. Available studies that investigated the efficacy of levetiracetam and sodium valproate on BECTS involved small sample sizes. This study aimed to evaluate the efficacy of levetiracetam and sodium valproate on cognition, and to investigate the prognostic factors for BECTS as whole.Methods: Clinical data and treatment status of all patients with BECTS at Xiangya Hospital, Central South University followed from 2008 to 2013 were analyzed retrospectively. Since electrical status epilepticus in sleep (ESES) has been confirmed to play a role in cognitive deterioration, in order to evaluate the response to drugs and their cognitive effects, we created two groups of patients according to the levels of spike wave index (SWI): group 1; 0–50% SWI and group 2; >50% SWI at the last follow up.Results: A total of 195 cases were enrolled: 49.7% received monotherapies, 24.1% duotherapies and 27.2% polytherapies. Medications included; levetiracetam plus other drug (s) (75.9%), levetiracetam alone (32.8%), sodium valproate plus other drug (s) (31.3%), and sodium valproate alone (5.1%). After 2 years of treatment and follow up, 71% of the cases had a good seizure outcome, 15.9% had an improvement of SWI, and 91.7% had a normal DQ/IQ. Sodium valproate combined with levetiracetam, and sodium valproate alone correlated with good improvement of SWI, whereas, focal spikes were linked with poor improvement. For both groups (group 1 and group 2): monotherapy, levetiracetam alone, and a normal DQ/IQ at seizure onset correlated with good cognitive outcomes, in contrast, polytherapy, sodium valproate plus other drug (s), levetiracetam plus sodium valproate, an initial SWI of ≥85%, and multifocal spikes were linked to cognitive deterioration.Conclusions: Monotherapy, particularly levetiracetam seems to be a good first-line therapy which can help in normalizing the electroencephalograph and preventing cognitive decline. Polytherapy, mostly the administration of sodium valproate seems to relate with poor cognition, therefore, it is recommended to avoid it.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Treatment for the Benign Childhood Epilepsy With Centrotemporal Spikes: A Monocentric Study

et al. 2021

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“…Regarding treatment, recent study from Iran[ 11 ] proposed levetiracetam as monotherapy as an alternative to carbamazepine which can cause side effects such as skin rash and intolerance. However, we used carbamazepine alone in 58.62% of our cases without side effects and levetiracetam is more expensive.…”

Section: Discussionmentioning

confidence: 99%

Clinical profile of patients with rolandic epilepsy at a clinic in rural Maharashtra

Sable¹,

Sable²,

Tamhankar

et al. 2021

Journal of Family Medicine and Primary Care

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Purpose: To describe the seizure pattern, treatment strategies and outcome in a series of children with Rolandic seizures or childhood epilepsy with centrotemporal spikes. Materials and Methods: Patients were defined as Rolandic epilepsy if on electroencephalographic studies high voltage spike and waves were seen in centrotemporal areas, could be followed by slow waves, often activated on sleep and could shift from one side to other or be secondarily generalized. Typical (TRS) or benign were those with normal intellect. Atypical rolandic seizures (ARS) were those associated with neuroregression of language and cognitive milestones. Patients were treated with antiepileptic drugs if more than one episode occurred or the first episode was generalized status epilepticus. Results: Thirty-three patients were included over the period of eight years (2012-2020). There was male preponderance (21 males versus 12 females). Four patients (12.12%) later evolved into Landau Kleffner syndrome (ARS group). The mean age of onset of epilepsy in the TRS group (29 patients) was 7.2 (+/-2.2) with the youngest patient being 4 years and the eldest being 12 years. In the ARS group the mean age of onset was 5 yrs. (+/-1.41). In the TRS group, 23 (79.31%) patients were managed on monotherapy AED. Seventeen patients (58.62%) responded (remission) to carbamazepine monotherapy alone. Six patients (20.68%) could afford oxcarbazepine monotherapy and went in remission with this therapy. In the ARS group all patients required three drugs (valproate, clobazam and levetiracetam). By the end of the study period, 23/33 (75.75%) patients remained seizure free. Conclusions: Most patients with rolandic seizures have excellent prognosis being seizure free around puberty. The neurological outcome in most patients was normal.

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“…In these trials, LEV monotherapy's e cacy in children is almost equally comparable to other AEDs, specially CBZ as rst-line therapy. Also, they recommended conducting RCTs with larger sample sizes to compare the e cacy and adverse effects of LEV monotherapy in children more accurately (18,19). Due to the limited number of comparing trials on LEV and CBZ monotherapy and the importance of choosing a suitable drug for controlling pediatric focal seizures, this randomized clinical trial was conducted in children with focal epilepsy to investigate and evaluate the e cacy and side effects of both therapies.…”

Section: Introductionmentioning

confidence: 99%

Safety and efficacy of levetiracetam and carbamazepine monotherapy in the management of pediatric focal epilepsy: a randomized clinical trial

Montazerlotfelahi,

Haj Mohamad Ebrahim Ketabforoush,

Tavakol

et al. 2024

Naunyn-Schmiedeberg's Arch Pharmacol

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Background: Due to the limited number of studies in children with focal epilepsy and the importance of choosing the most suitable drug to control seizures in children, the administration of the most effective medication with the most negligible side effects is vital.Objectives: This study aimed to evaluate the effectiveness and side effects of Carbamazepine vs.Levetiracetam monotherapy in children with focal seizures. Design: A monocentric, randomized, controlled, double-blind, parallel-group clinical trial Setting: This study was approved by the Iranian Registry of clinical trials (registration number:

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A comparative study on the efficacy of levetiracetam and carbamazepine in the treatment of rolandic seizures in children: An open-label randomized controlled trial

Cited by 9 publications

References 31 publications

Treatment for the Benign Childhood Epilepsy With Centrotemporal Spikes: A Monocentric Study

Treatment for the Benign Childhood Epilepsy With Centrotemporal Spikes: A Monocentric Study

Clinical profile of patients with rolandic epilepsy at a clinic in rural Maharashtra

Safety and efficacy of levetiracetam and carbamazepine monotherapy in the management of pediatric focal epilepsy: a randomized clinical trial

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