Abstracts

RATIONALE: Levetiracetam (LEV) has been approved for use as add-on therapy for patients with partial seizures with or without secondary generalization. Preclinical studies have shown efficacy of LEV in monotherapy. We wanted to determine if LEV could be used in monotherapy in a variety of seizure types. At the end of this activity, participants should be able to appreciate off-label uses of LEV.
METHODS: Charts of all patients with epilepsy followed at the Duke Epilepsy Center and the Neurodiagnostic Center, Durham Veterans Affairs Medical Center were reviewed and patients on LEV were identified. From these patients, only those using LEV as the sole antiepileptic drug (AED) were further evaluated. Patients on other AEDs for reasons other than epilepsy were also excluded. The characteristics of the remaining patients were analyzed.
RESULTS: Of over 300 patients on LEV, 21 were taking it as monotherapy for epilepsy. The mean age of these 21 patients was 42.8 years (range 16-66 years); there were 11 women and 10 men. The mean duration of follow-up was 8.7 months (range 3-23 months). Eighteen (86%) had complex partial seizures with or without secondary generalization. Three (14%) had generalized epilepsy, one with childhood absence epilepsy, one with juvenile myoclonic epilepsy and one with epilepsy with grand mal seizures on awakening. The mean dose was 1619 mg (range 500-3000 mg). All but three patients had been seizure-free since LEV monotherapy was started. Only one patient complained of side effects of diffuse dysesthesias in the extremities and scalp.
CONCLUSIONS: LEV is an effective AED in monotherapy in partial seizures. It may also be useful in various primary generalized epilepsies as well.
[Supported by: Research supported in part by UCB Pharma.]; (Disclosure: Consulting - Ortho McNeill Pharmaceuticals, Honoraria - UCB Pharma, GSK Pharmaceuticals)