Abstracts

Rationale: The aim was to investigate the efficacy and safety of levetiracetam (Keppra) in individuals with intellectual disabilities who have uncontrolled partial or generalised epilepsy. Methods: An open label prospective study compared seizure frequency, unwanted medication side effects, participant challenging behaviour, carers’ concerns about epilepsy and perceived participant quality of life between a baseline observation prior to the use of levetiracetam and follow-up observations at 3, 6, 9 and 12 months afterwards. Seizure frequency and side effects were assessed using individualized seizure diaries spanning the periods between study visits. Challenging behaviour, carers’ concerns about epilepsy and perceived quality of life were measured using established scales. Results: Recruitment was low (n=42), with six participants not entering the trial. Two participants withdrew at initiation of treatment, one with worsening seizures and one with a rash, and a further one later on in treatment with a rash; all were felt to be drug related. Three other participants withdrew for independent reasons. Thirty participants received levetiracetam and had at least 6 months follow up data collected. 26 participants (mean age 40, range 18-65) reached the final data point. Median weekly seizure frequency was reduced from baseline levels of 4.2 to average post-intervention levels of 2.2 this change was statistically significant (z = -2.53, p= .011). No significant change in challenging behaviour was found using the Aberrant Behaviour Checklist (baseline median = 18.0, average post-intervention median = 19.3, z = -.15, p = .988). Patient concerns about seizures and medical treatment significantly declined and perceived quality of life relating to seizure severity improved. Side effects peaked immediately after initiation of levetiracetam but declined to baseline levels by study completion. Conclusions: Overall, despite the small numbers, levetiracetam was shown to have a significant positive impact on seizure reduction, carer concerns and perceived quality of life, without undue behavioural or other side effects. (Source of Funding: This project was supported by an unrestricted grant from UCB Pharma Ltd)