Levetiracetam may be effective in children with acute
seizures or
status epilepticus. We performed a retrospective chart review of children who received intravenous
levetiracetam within 30 minutes of a seizure. Seventy-three patients during a 2-year study period met our inclusion criteria. The mean (+/- S.D.) age and weight of the patients were 5.59 +/- 5.6 years (range, 1 day to 17.8 years) and 23.1 +/- 21 kg (range, 1.97-97 kg), respectively. Patients received a mean (+/- S.D.)
levetiracetam dose of 29.4 +/- 13.5 mg/kg. Most children (n = 49, or 67%) received additional
antiepileptic drugs to abort their seizure. Overall, the mean (+/- S.D.) total (abortive plus chronic) number of concomitant
antiepileptic drugs used by the population was 2.53 +/- 1.7 (1.07 +/- 0.98 as additional abortive
therapy, and 1.42 +/- 1.29 as chronic
therapy). Most patients received
levetiracetam for serial
seizures (79%), whereas 12% and 8% manifested a
single seizure or
status epilepticus, respectively. Clinical effectiveness at 1, 12, 24, 48, and 72 hours after the initial
levetiracetam dose constituted the primary study outcome. Eighty-nine percent of patients remained seizure-free at 1 hour. This rate decreased at each evaluation time point. Most patients (71%) were placed on maintenance
levetiracetam within 24 hours of their loading dose. The predictive ability of patient and
drug regimen variables in outcomes was poor. Only the number of concomitant
antiepileptic drugs consistently predicted outcomes.
Levetiracetam was well tolerated at the doses studied, and appears most effective in
single seizure events.