Intravenous Levetiracetam in Children with Acute Prolonged Seizures

Yang, Im Yong; Yum, Mi Sun; Kim, Eun Hee; Choi, Hae Won; Ko, Tae Sung

Abstract

PURPOSE
Acute repetitive seizures and status epilepticus constitute one of the major medical emergencies in children. The aim of this study was to evaluate the effectiveness and safety of intravenous (IV) levetiracetam in children with these conditions.
METHODS
We reviewed medical records of the patients who received IV levetiracetam (LEV) to treat acute repetitive seizures or status epilepticus from April, 2010 to September, 2012. Patients were sub-grouped for evaluating the effectiveness and safety of IV LEV according to their underlying etiology, seizure types, previous antiepileptic medication, and febrile conditions at the time of seizures.
RESULTS
Forty patients (age range, 53 day to 15 years) were treated with 30 mg/kg of IV levetiracetam. Twenty five of 40 patients (62.5%) became and remained seizure-free. IV levetiracetam was more effective in patients with generalized tonic clonic seizures than those with other seizure types (P=0.024). No other clinical factors affected the efficacy of IV levetiracetam. Irritability and aggressive behavior were noted in four children during the maintenance and one of whom needed to discontinue LEV.
CONCLUSION
This study showed that IV levetiracetam therapy was effective and safe in children with acute prolonged seizures, especially with generalized tonic clonic seizures. Further randomized controlled studies are needed to determine the efficacy and safety of LEV over the conventional IV antiepileptic drugs.