LEVETIRACETAM AS ADD-ON THERAPY IN 25 CHILDREN WITH MYOCLONIC EPILEPSY

Objectives: To assess the efficacy and safety of levetiracetam as add-on therapy in 25 children with myoclonic epilepsy.

Methods: We have reviewed the clinical records of 25 consecutive pediatric patients with myoclonic epilepsy (mean age: 7 years; range: 6 months to 18 years) prescribed levetiracetam for at least six months. The epilepsy was considered idiopathic in 5 patients (20%), cryptogenic in 8 (32%) and symptomatic in 12 (48%) including 5 patients with progressive myoclonic epilepsy (four mitochondrial disorders and one Niemann-Pick C disease).

Results: Twenty patients (80%) showed a seizure frequency reduction of more than 50% including 7 patients (28%) who became seizure-free. All patients (three cases) with juvenile myoclonic epilepsy were seizure-free after six months of treatment. Levetiracetam was generally well tolerated although 7/25 (28%) of patients reported side-effects. Somnolence was the most commonly reported adverse event (20%). Levetiracetam was stopped in 5 patients (20%), two because of side-effects (irritability and hyperactivity) and three though lack of efficacy. Conclusion: Levetiracetam is effective, safe and well tolerated in infants, children and adolescents with myoclonic epilepsy. Some patients demonstrating only a partial response at a dosage of 50–60mg/Kg/day may become seizure-free when they are treated with a final dosage of 100mg/Kg/day.