Abstracts

To determine if levetiracetam can improve neuropsychological functioning in children manifesting evidence of subclinical spike production., Subjects with learning difficulties and EEG findings of focal spike discharges, and Leiter-R scores greater than 70, were enrolled. Neuropsychological testing (Wide Range Assessment of Memory and Learning [WRAML-2], Wechsler Individual Achievement Test [WIAT-II]-abbreviated) was completed at baseline and after 10 weeks of levetiracetam (40mg/kg/day.) Digital 128 channel dense-array EEG recording (Electrical Geodesics, Inc) was done throughout each testing session. The difference of pre- and post-treatment scores (i.e. post-treatment minus pre-treatment) was compared to both the Standard Error of Measurement (SEM) for each index, and the standard re-test gain for each subtest. Difference scores which were larger than the combined SEM and re-test gain for that index or subtest were considered to indicate significant improvement., Three subjects were enrolled, 2 females, 1 male (mean 9.5 years.) Results of the WRAML-2 showed a significant improvement on all indexes for two subjects, and on two indexes for the third participant. Results of the WIAT-II-abbreviated did not reveal significant subtest pre-post difference scores, but there were two significant subtest improvements for one subject., Overall, the results strongly support the hypothesis that post-treatment scores for memory and attention (WRAML-2) were significantly higher than would be predicted based on the combined consequences of error and practice effects, suggesting that levetiracetam was efficacious in improving memory and attention in this cohort. Academic achievement scores (WIAT-II-abbreviated) were not significantly changed. However, academic achievement will lag by months after improvement in memory and attention. Therefore, further research is planned to determine whether the initial improvements on attention and memory may result in later improvements on academic achievement, and in determining if the findings correlate to spike quantity or localization.[table1], (Supported by UCB Pharma.)