| Title | Levetiracetam in children with refractory epilepsy: Lack of correlation between plasma concentration and efficacy. | | Author(s) | Giroux PC, Salas-Prato M, Théorêt Y, Carmant L | | Institution | Department of Physiology, University of Montreal, C.P. 6128, succursale Centre-ville, Montréal, Québec, Canada H3C 3J7; Department of Pediatric, University of Montreal, CHU Sainte-Justine, 3175, Côte Sainte-Catherine, Montréal, Québec, Canada H3T 1C5. | | Source | Seizure 2009 Jun 20. | | Abstract | PURPOSE: The goals of this study are to evaluate the efficacy and tolerability of levetiracetam (LEV) as add-on therapy in children with refractory epilepsies and to determine the value of LEV blood level monitoring in this population.
METHODS: Sixty-nine children (39 males and 30 females) treated with LEV between 2006 and 2007 were selected. Their medical files were reviewed for LEV efficacy and tolerability. In a subgroup of children currently taking LEV, plasma concentrations were determined by high performance liquid chromatography by ultraviolet detection (HPLC-UV) method and correlated with the given dose per kilo as well as clinical response.
RESULTS: Fifty-one patients (74%) had a more than 50% reduction in seizure frequency with 16 patients (23%) becoming seizure free on LEV. Eighteen (26%) patients had a less than 50% reduction in seizure frequency. Adverse events due to LEV ranged from mild to moderate in only 18 patients (26%). The most frequently observed were drowsiness, behavioral difficulties, increase in seizure frequency and headaches. The majority (60.5%) of the responders received doses between 10 and 50mg/kg/day and had a plasma concentration (PC) between 5 and 40mug/ml. However, we found no clear correlation between PC and efficacy.
CONCLUSION: Levetiracetam given twice a day in children with refractory epilepsy reduces seizure frequency in all types of epilepsy. In children, LEV is a broad spectrum anticonvulsant with a favourable safety profile. | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 19546014 |
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