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Levetiracetam Effective Adjunctive Treatment For Epilepsy In Those Who Failed Surgery
A DGReview of :"Levetiracetam Efficacy in Refractory Partial-onset Seizures, Especially after Failed Epilepsy Surgery."
Epilepsia
02/18/2003
By Alison Palkhivala
Levetiracetam may be a useful adjunctive therapy for the management of partial-onset epilepsy, particularly in patients who did not respond to epilepsy surgery in the temporal region of the brain. Patients should be monitored for potential psychotic reactions, however.
M. Motamedi from the department of neurology, Yale University School of Medicine, New Haven, Connecticut, United States, and colleagues performed a retrospective study evaluating the efficacy of levetiracetam as an adjunctive therapy for the treatment of localization-related epilepsy. The investigators were particularly interested in its efficacy among patients for whom surgery was not effective.
Among the 82 patients with uncontrolled, partial-onset epilepsy who were taking levetiracetam, 21 had not responded to epilepsy surgery and 61 had never undergone epilepsy surgery. These two groups of patients were similar with respect to age and age at seizure onset.
The response rate to levetiracetam, defined as at least a 50% reduction in seizure frequency, was 76.1% in patients for whom surgery had failed. Among these patients, 10 (47.6%) became seizure-free with the drug. Response rates were better among patients who received surgery in the temporal region, compared with patients who received surgery elsewhere (91.6 versus 55.5%, respectively).
In patients who had never received surgery, the response rate to levetiracetam was 34.3%, and 9 patients (14.7%) became seizure-free.
Three patients who responded to levetiracetam, all of whom had received epilepsy surgery, experienced severe, delayed psychotic syndromes four to nine months after initiation of the drug. These patients had to discontinue the agent.
Epilepsia 2003 Feb;44:2:211-4.
"Levetiracetam Efficacy in Refractory Partial-onset Seizures, Especially after Failed Epilepsy Surgery."
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