Levetiracetam may be more effective for late-onset partial epilepsy

Arch Neurol. 2002 Dec;59(12):1905-8. doi: 10.1001/archneur.59.12.1905.

Abstract

Background: Many agents are available for treating epilepsy; however, population studies have failed to show overall differences in efficacy for a given seizure type. Clinical experience suggests that certain individuals will respond to a given agent while others with the same seizure type will not.

Objectives: To examine a population of patients who received one of the newer antiepileptic drugs, levetiracetam, and to identify those who had either a dramatic improvement or a significant worsening of seizures.

Methods: Retrospective medical record review of patients with refractory epilepsy.

Results: Patients who responded well to levetiracetam therapy were older at the onset of epileptic seizure than those who did not (mean [SD] age, 51 [5] vs 27 [3] years; P<.05). This was also true of the subset of patients who had localization-related epilepsy. Patients with temporal lobe onset were likely to do well whereas patients with frontal lobe onset were not.

Conclusions: These results suggest that certain subpopulations may be particularly likely to respond to levetiracetam therapy. These need to be confirmed in a larger prospective trial; however, looking for specific characteristics of patients who respond to certain drugs may lead to useful guidelines for drug choices in treating epilepsy.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Age of Onset
  • Anticonvulsants / therapeutic use*
  • Epilepsies, Partial / drug therapy*
  • Epilepsies, Partial / physiopathology
  • Female
  • Humans
  • Levetiracetam
  • Male
  • Middle Aged
  • Neuropsychological Tests / statistics & numerical data
  • Piracetam / analogs & derivatives*
  • Piracetam / therapeutic use*
  • Postoperative Period
  • Preoperative Care / statistics & numerical data
  • Retrospective Studies
  • Verbal Learning

Substances

  • Anticonvulsants
  • Levetiracetam
  • Piracetam