"Headaches are common and disabling in children and adolescents, and have been reported to account for 25% of all new patient diagnoses in a paediatric neurology clinic," said Inna I. Vaisleib, MD, assistant professor of paediatrics and neurology, University of Pittsburgh, and neurologist, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, United States.

"Our findings suggest that levetiracetam can be an effective and well-tolerated agent for the prophylactic treatment of migraine headaches in children, and may be useful for clinicians to consider in selecting a treatment medication," she said at her poster presentation.

In the 10-week, open-label study of 30 children, the average number of headaches was reduced from 14.5 per month to 3 per month, said Dr. Vaisleib. That difference in outcome was statistically significant at the P <.05 level, she said.

"Up to 10.6% of children ages 5 to 15 and 28% of adolescents ages 15 to 19 may have migraine headaches," Dr. Vaisleib said. "Historically, many anticonvulsants have been used with success for prophylactic treatment of migraine headaches."

Dr. Vaisleib and her colleagues titrated the dose of levetiracetam over a 6-week period until it was effectively blocking migraine headaches. Once having achieved an effective dose, the dose was maintained for 4 weeks.

Patients were evaluated at baseline and at the end of the study with PedMIDAS (Pediatric Migraine Disability Assessment) questionnaire, which reflects the patient's quality of life. Children admitted into the study were between the age of 6 to 19 years and had migraine headaches at a frequency of 2 or more per week. The study was carried out at Children's Hospital of Pittsburgh.

Out of 25 patients who had at least 4 weeks of levetiracetam therapy, 80% had at least a 50% decrease in headache frequency, and 36% had at least a 75% decrease in headache frequency, while 12% reported being headache free. Headaches worsened in 16% of patients and did not change in 1 child (4%).

"The results of this trial," Dr. Vaisleib said, "may assist in the selection of the medication treatment of this common condition."

UCB Pharma, the company that markets Keppra, funded the study. The drug is currently approved by the US Food and Drug Administration as adjunctive treatment of partial onset seizures in adults.


[Presentation title: Role of Levetiracetam in Prophylaxis of Migraine Headaches in Childhood. Abstract P06.009]

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