Abstracts

Levetiracetam (LEV), a novel antiepileptic drug (AED), and piracetam (with a structure similar to that of LEV and proven to be effective in myoclonus) are pyrrolidone derivatives, a class of drugs not previously used in epilepsy. LEV, approved in the USA and Europe as add-on therapy for the treatment of patients with refractory partial seizures (Cereghino [italic]et al. [/italic]2000; Shorvon [italic]et al[/italic] 2000; Ben Menachem and Falter, 2000), has been widely shown as effective and well tolerated. Motamedy [italic]et al[/italic]. (2003) has reported that of 21 patients operated on unsuccessfully for refractory epilepsy 47.6% became seizure-free after at least 3 months of treatment with 1000-3000 mg of LEV and 28.5% showed a reduction in seizure frequency of more than 50%.
We evaluated the efficacy of LEV treatment in patients with generalised seizures. Eight (8) patients (5 female, 3 male, aged 16-62 years) were include in our study. Three (3) patients had absence epilepsy, 3 primary generalised tonic-clonic seizures and 2 had juvenile myoclonic seizures. Doses of LEV varied between 1500 and 4000 mg/day. In all patients LEV was used as add-on therapy. The goal of our study is to treat all patients on LEV monotherapy so we are gradually reducing (and hoping to cease) their other AED therapy to achieve this goal. All patients improved both clinically and electroencephalographically after commencing LEV therapy with a reduction in seizure frequency of at least 50%. In 2 of them (1 with absence epilepsy and 1 with myoclonic seizures) their previous AED therapy (valproate), to which LEV had been added, was gradually reduced and then stopped leaving them on LEV monotherapy. Both these patients were seizure-free. Our study has shown that patients with primary generalised epilepsy can be treated successfully with LEV initially used as add-on therapy, then withdrawn to monotherapy. Further studies are required to support our findings.