The efficacy and safety of levetiracetam (LEV) as adjunctive therapy were evaluated in 23 children (aged 6-12 years) with monotherapy-resistant partial-onset seizures at Children’s Hospital Medical Center, Cincinnati, OH and other major centers. Seizure frequency during an 8-week evaluation period with individualized LEV doses (20-40 mg/kg/day) was compared with the 4-week baseline seizure frequency. Seizure frequency was reduced by >50% in 12 (52%) patients. Plasma concentrations of concomitant AED (carbamazepine or valproic acid) were not affected. Adverse events included headache (33%), anorexia (25%), and somnolence (25%). No alterations in mean clinical laboratory values were observed. A decrease in red blood cell count occurred in 1 patient, and thrombocytopenia in one was attributed to concomitant valproic acid treatment. [1]

COMMENT. Levetiracetam (Keppra®), an adjunctive therapy for partial seizures in adults, is shown to be effective and relatively safe in children, by open-trial. A randomized, placebo-controlled, double-blind trial is ongoing.

In an editorial [2], Levetiracetam, introduced in 1999, is described as a broad spectrum AED, twice-daily dosing, unique mechanism of action, low toxicity, low protein binding, low risk of rash, and no drug interactions. Sedation is the main disadvantage, occurring in 15% of patients.