Evaluation of the Levetiracetam treatment on reduction of epileptic discharges in electroencephalogram in children with epilepsy.
Iranian Journal of Child Neurology,
Vol. 15 No. 4 (2021),
1 October 2021
https://doi.org/10.22037/ijcn.v16i1.30946
Abstract
Abstract:
Objectives: Epilepsy is a relatively common disease in childhood. In some patients, despite clinical control of seizures, the electroencephalogram (EEG) is clearly abnormal. In some studies, the adverse effects of epileptic discharges on cognition, learning, behavior, and seizure recurrence in children have been identified. In this study, the effect of Levetiracetam on epileptic discharges in the interictal phase of EEG in children with epilepsy was investigated.
Materials and Methods: In this clinical trial, 59 children aged 2 to 15 years with epilepsy, whose clinical seizures were controlled by sodium valproate in the last six months, but they still had epileptic discharges in the EEG, were randomly divided into two groups. Intervention group (24 people), whom Levetiracetam was added to sodium valproate, and control group, whom treatment with sodium valproate (35 people) alone was continued, then the patients were followed for one year.
Results: The frequency of normalization of epileptic discharges in the intervention and control group was 66.7% and 57.1% (P = 0.500), respectively. The mean time for normalization of epileptic discharges in the interictal phase was 14.55%±14.31% months in the intervention group and 12.50%±20.18% months in the control group (P = 0.033).
Conclusion: In children with controlled seizures whose EEG was still abnormal, both sodium valproate therapy alone and sodium valproate combined with Levetiracetam were effective in reducing the severity of epileptic discharges. But addition of Levetiracetam to sodium valproate normalizes EEG more rapidly.
- Levetiracetam
- Sodium Valproate
- Epileptic discharges
- Interictal phase.
How to Cite
References
References:
Camfield P, Camfield C. Incidence, prevalence and aetiology of seizure and epilepsy in children. Epileptic Disord 2015; 17(2):117-123.
Aaberg K M, Gunnes N, Bakken I J, Soraas C L, Berntsen A, Magnus P, et al. Incidence and Prevalence of Childhood. Pediatrics 2017; 139(5): e20163908.
Sanchez Fernandez I, Loddenkemper T. Interictal epileptiform discharges and
cognition. Developmental Medicine & Child Neurology 2017; 59(1):13-4.
Pressler RM, Robinson RO, Wilson GA, Binnie CD. Treatment of interictal epileptiform discharges can improve behavior in children with behavioral problems and epilepsy. The Journal of pediatrics 2005;146(1):112-7.
Karimzadeh P, Tonekaboni H., Shamsabadi MF. The Effects of Sodium Valproate in improving developmental delay in seizure-free children with abnormal electroencephalography. Iranian
Journal of Medical Sciences (IJMS) 2009; 34(2): 110- 115.
Kanemura H, Aihara M. EEG abnormalities in ADHD: How Should We treat? Pediat Therapeut
; 4(1): e12G
Chae K, Sung H, Kim D. Relationship between Seizure Recurrence and EEG by Epilepsy . Korean J Clin Lab Sci 2016; 48(4): 388-393.
Balagura G, Lapadre G, Verrotti A, Striano P. Moving beyond sodium valproate: Choosing the right anti-epileptic drug in children. Expert Opin Pharmacother 2019; 20(12): 1449-1456.
Kanemura H, Sano F, Tando T, Sugita K, Aihara M. Efficacy and safety of add-on levetiracetam in refractory childhood epilepsy. Brain and Development 2013;35(5):386-91.
Piña-Garza JE, Nordli Jr DR, Rating D, YangH, Schiemann-Delgado J, Duncan B, et al. Adjunctive Levetiracetam in infants and young children with refractory partial-onset seizures. Epilepsia 2009;50(5):1141-9.
Kanemura H, Sano F, Ohyama T, Aihara M. Efficacy of levetiracetam for reducing rolandic discharges in comparison with carbamazepine and valproate sodium in rolandic epilepsy. Seizure 2018;62:79-83.
Wang SB, Weng WC, Fan PC, Lee WT. Levetiracetam in continuous spike waves during
slow-wave sleep syndrome. Pediatric neurology 2008;39. 85-90:(2).
Specchio N, Boero G, Michelucci R, Gambardella A, Giallonardo AT, Fattouch J, et al. Effects of levetiracetam on EEG abnormalities in juvenile myoclonic epilepsy. Epilepsia 2008;49(4):663-9.
Bakke KA, Larsson PG, Eriksson AS, Eeg- Olofsson O. Levetiracetam reduces the frequency of interictal epileptiform discharges during NREM sleep in children with ADHD. European journal of paediatric neurology
;15(6):532-8.
Kanemura H, Sano F, Ohyama T, Sugita K, Aihara M. Effect of levetiracetam on behavioral problems in pervasive developmental disorder children with epilepsy. European Journal of
Paediatric Neurology 2014;18(4):482-8.
Stodieck S, Steinhoff BJ, Kolmsee S, van Rijckevorsel K. Effect of levetiracetam in
with epilepsy and interictal epileptiform discharges. Seizure 2001;10(8):583-7.
Levisohn PM, Mintz M, Hunter SJ, Yang H, Jones J, Group NLS. Neurocognitive effects
of adjunctive levetiracetam in children with partial-onset seizures: A randomized, doubleblind,
placebo-controlled, noninferiority trial. Epilepsia 2009;50(11):2377-89.
Liu Z, Li J, Yang F, Hu Y, Liu J, Hu H and et al. Sodium valproate combined with Levetiracetam in pediatric epilepsy and its influence on NSE, IL-6, hs-CRP and electroencephalogram improvement. Exp Ther Med 2020 Sep; 20(3): 2043–2048
- Abstract Viewed: 497 times