Abstracts

Levetiracetam is an antiepileptic medication approved by the FDA in 1999 for use as an adjunctive therapy for patients with partial onset seizures in adults. In addition, off label use of the medication is reported in children with partial onset seizure disorder. The objective of this study was to review two specific clinical outcomes of treatment as a measure of the effectiveness of Levetiracetam as adjunctive therapy: 1) normalization of the EEG tracing and 2) decreased frequency of seizures. A computer list of patients followed in the Stony Brook Epilepsy Clinic that are on Levetiracetam and who had EEG[apos]s performed via referral to the Stony Brook Electrophysiology Lab was generated. The patients[apos] ages ranged from three to eighty-five. Seizures were classified as partial seizures, complex partial seizures, partial seizures with secondary generalization and generalized seizures. Of the sixty patients listed, fifty charts were available for review. Twenty-three of the fifty patients had EEG[apos]s performed pre and post drug initiation. Seventeen (N=17) of the Twenty-three patients had abnormal EEG[apos]s at baseline. The follow up EEG[apos]s were reported for all patients. The seizure frequency was charted and compared with regards to seizure activity pre and post treatment. Four of the seventeen patients (23.5%) had abnormal EEG[apos]s that normalized; and, thirteen (76.4%) had abnormal EEG[apos]s that remained abnormal. The seizure frequency for eight patients (47%) decreased (five of the eight patients (24.4%) became seizure free); two patients (28.5%) had no changes in the seizure rate after treatment; six patients (35.2%) did not have adequate documentation for reporting. In this retrospective review there is inconclusive evidence that routine EEG[apos]s can be used as a measure of effective treatment with Levetiracetam with regards to normalization of the EEG tracing. However, the primary data presented is supportive that the seizure frequency of patients treated with Levetiracetam is reduced despite persistent abnormalities in the EEG. A larger prospective study is suggested to evaluate the impact of Levetiracetam on EEG and seizure frequency.