Levetiracetam in Childhood Epilepsy

Abstract

Levetiracetam is an antiepileptic drug that has been shown to be effective in various types of seizures, both partial and generalized. Although it is not yet well established because of the small number of studies, levetiracetam as both add-on therapy and monotherapy can be considered as an alternative to valproic acid in some pediatric patients. We have reviewed the available data on the efficacy, tolerability, and safety of levetiracetam in children with epilepsy. The efficacy of levetiracetam as an adjunctive therapy and as monotherapy for generalized and partial childhood epilepsies and for some types of specific epileptic syndromes of infancy and childhood (such as juvenile myoclonic epilepsy, benign rolandic epilepsy, and Jeavon syndrome) has been demonstrated in some studies. Moreover, levetiracetam may be a valuable option for children with refractory epilepsy. The reported tolerability of levetiracetam and its safety profile are favorable. Among the side effects reported, behavioral changes and even psychotic reactions seem to occur more frequently in younger patients (under 4 years of age). The onset of signs/symptoms usually occurs early, even during the titration phase, and, in many cases, at a low dosage (<20 mg/kg/day). These side effects were always observed to be reversible after discontinuation of levetiracetam. In conclusion, results from clinical trials to date suggest that levetiracetam has a full spectrum of efficacy as well as a favorable safety profile, and this drug can be considered a valuable option in the treatment of epilepsy in pediatric patients.

Levetiracetam Monotherapy in Children with Epilepsy: A Systematic Review

“…This is in line with the most commonly reported adverse events for levetiracetam [55]. In children with pre-existing behavioural problems, the problems could be exacerbated during levetiracetam therapy [56]. In some, but not all, of the prospective studies, pre-existing behavioural and/or cognitive problems were exclusion criteria [24, 26–29].…”

Safety and Tolerability of Antiepileptic Drug Treatment in Children with Epilepsy

“…+ [52] Depression + [31] + [53] + [52,54] Suicidal ideation + [53] Behavioural problems + [39,55] + [30,56] + [51,57] + [40] + [32,58] + [59,60] + [45] + [46] + [41][42][43] + [35] + [36,37,49,52] + [38,50] Hallucinations/psychosis + [37] Blurred vision/visual field deficits + [51,63] + [53] Diplopia/eye movement abnormalities…”

Levetiracetam Extended Release as Adjuvant Therapy for the Control of Partial-onset Seizures

“…However conclusions can be driven from the data available for LEV-IR. The efficacy of LEV-IR as an adjunctive therapy or monotherapy for generalized and partial childhood epilepsies and for some types of specific epileptic syndromes of infancy and childhood (such as juvenile myoclonic epilepsy, benign rolandic epilepsy, and Jeavon syndrome) has been demonstrated in several studies 36. The reported tolerability of LEV-IR and its safety profile were favorable.…”