Levetiracetam (levebel) Versus Carbamazepine Monotherapy for Focal Epilepsy in Children
Iranian Journal of Child Neurology,
Vol. 14 No. 2 (2020),
1 April 2020
,
Page 69-77
https://doi.org/10.22037/ijcn.v14i2.13685
Abstract
Focal epilepsy is one of the most prevalent type of seizures in childhood. In this study we will compare the effect of new approved drug leveitiracetam versus carbamazepine in the treatment of focal epilepsy.
Methods and Materials:
we studied newly diagnosed children with focal epilepsy (in the age range of 1-16). The children were treated randomly with two drug levetiracetam and carbamazepine. Patients have been followed for seizure and drugs side effects at intervals of 1 month and six months. We checked liver function tests and complete blood count for all patients and they asked about any significant side effects such as drowsiness، restlessness and skin reaction. Eventually, they were classified in two groups of 25 consuming levetiracetam and 25 consuming carbamazepine.
Results:
In our study, two cases were excluded in levetiracetam group because of sever agitation and 3 patients (13%) had relapsing seizures. In the group of carbamazepine,10 patients(40%) had relapse. Seizure was not repeated in 15 (60%) and 20 (87%) cases in carbamazepin and levetiracetam groups, respectivelly.
chi square examination showed that the responses to treatment had significant differences (P=0.03). Agitation and drowsiness were the most prevalent complication in levetiracetam and carbamazepine groups, respectivelly. Fortunately ،liver enzyme dysfunction and blood cell disturbance were observed in none of the groups.
Conclusion: According to findings, there were significant differences in controlling seizures between two groups that implicate much more influence of levetiracetam (87%) in suppression of focal seizure .
- focal epilepsy
- carbamazepine
- levetiracetam
- Effectiveness
How to Cite
References
References:
Glauser T, Ben-Menachem E, Bourgeois B, et al. ILAE treatment guidelines: evidence-based analysis of antiepileptic drug efficacy and effectiveness as initial monotherapy for epileptic seizures and syndromes. Epilepsia. 2006;47:1094-1120.
Douglas R, Nordli J. Focal and multi focal seizurfes. In: Swaiman KF, editor. Swaiman pediatric neurology. 5 ed. New York: Elsevier; 2012. p. 751-7.
Connock M, Frew E, Evans BW, et al. The clinical effectiveness and cost-effectiveness of newer drugs for children with epilepsy. A systematic review. Health Technol Assess. 2006;10:ix-118.
Ben-Menachem E, Falter U, for the European Levetiracetam Group.Efficacy and tolerability of levetiracetam 3000 mg/d in patients with refractory partial seizures: a multicenter double-blind, responder selected study evaluating monotherapy. Epilepsia 2000;41:1276–1283.
lawrence D, pellok M, Pellok J. Status epilepticus. In: Swaiman KF, editor. Swaiman pediatric neurology. New York: Elseview; 2012. p. 798-808.
Weijenberg A, Brouwer OF, Callenbach PM., et al. Levetiracetam Monotherapy in Children with Epilepsy: A Systematic Review.CNS DRUGS. 2015; 29(5):371-82.
Sachdeo R. Challenging our past paradigm in the management of epilepsy.Neurology 2000;55 (suppl 3):S1–S4.
Lin SC. Sample size for therapeutic equivalence based on confidence interval. Drug Info J 1995;29:45–50.
Bergin AM, Connolley M. New antiepileptic drug therapies. Neurol. Clin.20(4), 1163–1182 (2002).
Perucca E, Tomson T. Monotherapy trials with the new antiepileptic drugs: study designs, practical relevance and ethical implications. Epilepsy Res 1999;33:247–262.
Perry S, Holt P, Benatar M. Levetiracetam versus carbamazepine monotherapy for partial epilepsy in children less than 16 years of age. Journal of child neurology. 2008;23(5):515-9. Epub 2008/01/10.
Khurana DS, Kothare SV, Valencia I, et al. Levetiracetam monotherapy in children with epilepsy. Pediatr Neurol.2007;36:227-230.
Brodie MJ, Perucca E, Ryvlin P, et al. Comparison of levetiracetam and controlled-release carbamazepine in newly diagnosed epilepsy. Neurology. 2007;68:402-408.
Ben-Menachem E, Falter U. Efficacy and tolerability of levetiracetam 3000 mg/d in patients with refractory partial seizures:a multicenter, double-blind, responder-selected study evaluating monotherapy. European Levetiracetam Study Group. Epilepsia.2000;41:1276-1283.
Opp J, Tuxhorn I, May T, Kluger G, Wiemer-Kruel A, Kurlemann G, et al. Levetiracetam in children with refractory epilepsy: a multicenter open label study in Germany. Seizure : the journal of the British Epilepsy Association. 2005;14(7):476-84. Epub 2005/09/27.
Schiemann-Delgado J, Yang H, Loge Cde L, Stalvey TJ, Jones J, Legoff D, et al. A long-term open-label extension study assessing cognition and behavior, tolerability, safety, and efficacy of adjunctive levetiracetam in children aged 4 to 16 years with partial-onset seizures. Journal of child neurology. 2012;27(1):80-9.
Glauser TA, Ayala R, Elterman RD, Mitchell WG, Van Orman CB, Gauer LJ, et al. Double-blind placebo-controlled trial of adjunctive levetiracetam in pediatric partial seizures. Neurology. 2006;66(11):1654-60. Epub 2006/04/28.
Pina-Garza JE, Nordli DR, Jr., Rating D, Yang H, Schiemann-Delgado J, Duncan B. Adjunctive levetiracetam in infants and young children with refractory partial-onset seizures. Epilepsia. 2009;50(5):1141-9. Epub 2009/02/27.
Levisohn PM, Mintz M, Hunter SJ, Yang H, Jones J. Neurocognitive effects of adjunctive levetiracetam in children with partial-onset seizures: a randomized, double-blind, placebo-controlled, noninferiority trial. Epilepsia. 2009;50(11):2377-89. Epub 2009/08/26.
Callenbach PM, Arts WF, ten Houten R, Augustijn P, Gunning WB, Peeters EA, et al. Add-on levetiracetam in children and adolescents with refractory epilepsy: results of an open-label multi-centre study. European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society. 2008;12(4):321-7. Epub 2007/10/24
- Abstract Viewed: 534 times