Efficacy and tolerability of levetiracetam for pediatric refractory epilepsy.

Autor: Muramatsu K; Department of Pediatrics, Gunma University Graduate School of Medicine, Gunma, Japan; Department of Pediatrics, Maebashi Red Cross Hospital, Gunma, Japan. Electronic address: kaz-mura@gunma-u.ac.jp., Sawaura N; Department of Pediatrics, Gunma University Graduate School of Medicine, Gunma, Japan., Ogata T; Department of Pediatrics, Gunma University Graduate School of Medicine, Gunma, Japan., Makioka N; Department of Pediatrics, Gunma University Graduate School of Medicine, Gunma, Japan., Tomita K; Department of Pediatrics, Gunma University Graduate School of Medicine, Gunma, Japan; Department of Pediatrics, JCHO Gunma Chuo Hospital, Gunma, Japan., Motojima T; Department of Pediatrics, Gunma University Graduate School of Medicine, Gunma, Japan; Department of Pediatrics, Motojima General Hospital, Gunma, Japan., Ida K; Department of Pediatrics, Gunma University Graduate School of Medicine, Gunma, Japan; Department of Pediatrics, Isesaki Municipal Hospital, Gunma, Japan., Hazama K; Department of Pediatrics, Gunma University Graduate School of Medicine, Gunma, Japan., Arakawa H; Department of Pediatrics, Gunma University Graduate School of Medicine, Gunma, Japan.
Jazyk: angličtina
Zdroj: Brain & development [Brain Dev] 2017 Mar; Vol. 39 (3), pp. 231-235. Date of Electronic Publication: 2016 Oct 13.
DOI: 10.1016/j.braindev.2016.09.008
Abstrakt: Introduction: Levetiracetam has a high tolerability and is effective against various seizure types and epilepsy syndromes. However, no study has specifically evaluated the efficacy of levetiracetam in children with refractory epilepsy based on magnetic resonance imaging (MRI) findings and the presence of intellectual disability (ID).
Methods: We retrospectively evaluated levetiracetam efficacy and safety in 49 pediatric patients who met the following inclusion criteria: (1) diagnosis of refractory epilepsy with first-line antiepileptic (AED) treatment ⩾2years, (2) younger than 20years old, and (3) received oral levetiracetam treatment for ⩾6months. We assessed the relationships of these outcomes with MRI findings and ID status.
Results: Eighteen (37%) patients achieved a ⩾50% reduction in seizure frequency, and the majority (78%) had no remarkable side effects. Twenty-two (45%) patients had previously been treated with more than seven antiepileptic drugs prior to levetiracetam. Among 18 patients who achieved a ⩾50% reduction in seizure frequency, 13 and 5 had negative and positive MRI findings, and 9 and 9 had and did not have ID, respectively.
Conclusions: Our findings suggest that even for intractable pediatric cases with symptomatic etiology (i.e., MRI lesion and ID), levetiracetam has favorable efficacy for refractory epilepsy with tolerable adverse effects.
(Copyright © 2016 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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