Efficacy of Levetiracetam for Treatment of Drug-Resistant Generalized Epilepsy
Abstract number :
2.250
Submission category :
Year :
2001
Submission ID :
931
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
G.L. Krauss, MD, Neurology, Johns Hopkins University, Baltimore, MD; B. Abou-Khalil, MD, Neurology, Vanderbilt, Nashville, TN; S.G. Sheth, MBBS, MPH, Neurology, Johns Hopkins University, Baltimore, MD; J. Kelly, Neurology, Johns Hopkins University, Baltim
RATIONALE: Levetiracetam (LEV) is effective against partial-onset epilepsy, however, there is limited information about treatment effects for generalized epilepsy. LEV is effective against animal models of generalized seizures and human photoconvulsive discharges. We determined in an open-treatment series whether LEV is effective for treating seizures in patients with drug-resistant generalized epilepsy.
METHODS: Adult patients with generalized epilepsy treated with LEV at JHU and Vanderbilt were evaluated. Patients had generalized seizure types and generalized seizure discharges on EEG. Patients had failed treatment with other anticonvulsants. Patients were divided into idiopathic or symptomatic/cryptogenic generalized epilepsy based on seizure types, EEG, MRI and clinical examinations. Baseline monthly seizure frequencies were compared to monthly frequencies during 8 months of LEV treatment. Adverse events and LEV dosing were determined for the two periods.
RESULTS: A total of 36 patients were treated with LEV. Ages ranged from 17 to 52 years. A total of 27 patients (75%) had idiopathic generalized seizure syndromes; 9 (25%) had symptomatic/cryptogenic generalized seizures. A total of 15 patients (42%)became seizure-free with LEV treatment; 27 patients (75%) were seizure responders ([gt]50% reduction). Seven patients achieved LEV monotherapy. Median LEV dose was 1620 mg/d (500-4000 mg/d). Three patients (8%) discontinued LEV due to side-effects, including two due to mood abnormalities.
CONCLUSIONS: The majority of patients with generalized seizures (tonic-clonic, myoclonic, absence) who previously failed several anticonvulsants had marked seizure reduction with LEV, including 42% who became seizure free. LEV appears to be a promising broad-spectrum treatment for generalized, as well as partial-onset, epilepsy.
Disclosure: Consulting - Consultant, speakers bureau.