Levetiracetam efficacy in epileptic syndromes with continuous spikes and waves during slow sleep: experience in 12 cases

Author(s): Aeby A, Poznanski N, Verheulpen D, Wetzburger C, Van Bogaert P


Purpose:To assess the add-on efficacy of levetiracetam on the EEG, behavior, and cognition of children with continuous spikes and waves during slow sleep (CSWS).

Methods:Charts of children with behavioral and/or cognitive deterioration associated with CSWS who received levetiracetam at 50 mg/kg/day as add-on treatment were retrospectively reviewed. Awake and sleep EEG recordings and detailed neuropsychological and behavioral assessments were available at baseline and 2 months after levetiracetam initiation. In children showing clinical and/or electrophysiological improvement after 2 months, levetiracetam was continued with a new evaluation at 1 year.

Results:Twelve patients were included (9 cryptogenic and 3 symptomatic cases). Seven patients (58.3%) showed improvement of EEG record. Among these seven patients, neuropsychological evaluation was improved in three, and in the other four patients, not testable because of severe cognitive impairment, behavior was improved. Two patients improved in neuropsychological evaluation despite the lack of EEG improvement. Eight patients (66.6%) continued levetiracetam treatment after 2 months. After 1 year, four patients were still on levetiracetam, two because sustained effect on EEG and behavior and the two others because improvement in neuropsychological testing despite unchanged EEG. Levetiracetam was discontinued in the other four patients because of neuropsychological or behavioral deterioration associated with CSWS pattern, between 9 and 11 months after treatment initiation.

Conclusions:This retrospective study suggests that levetiracetam has a positive effect on the EEG, the behavior, and the cognition of patients with epilepsy and CSWS. Additional studies are warranted in order to assess the place of this drug in these epileptic conditions.

Similar Articles

Repeated seizures induce prefrontal growth disturbance in frontal lobe epilepsy

Author(s): Kanemura H, Sano F, Tando T, Sugita K, Aihara M

Correlation between cognition and behavior in epilepsy

Author(s): Cornaggia CM, Beghi M, Provenzi M, Beghi E

Frontal lobe epilepsy in childhood

Author(s): Sinclair DB, Wheatley M, Snyder T

MRI-based brain volumetrics: emergence of a developmental brain science

Author(s): Caviness VS Jr, Lange NT, Makris N, Herbert MR, Kennedy DN

Sequential 3-D MRI frontal volume changes in subacute sclerosing panencephalitis

Author(s): Kanemura H, Aihara M, Okubo T, Nakazawa S

EEG criteria predictive of complicated evolution in idiopathic rolandic epilepsy

Author(s): Massa R, de Saint-Martin A, Carcangiu R, Rudolf G, Seegmuller C, et al.

Development of mental health dysfunction in childhood epilepsy

Author(s): Noeker M, Haverkamp-Krois A, Haverkamp F

A detailed analysis of frontal lobe seizure semiology in children younger than 7 years

Author(s): Fogarasi A, Janszky J, Faveret E, Pieper T, Tuxhorn I

Repeated seizures induce prefrontal growth disturbance in frontal lobe epilepsy

Author(s): Kanemura H, Sano F, Tando T, Sugita K, Aihara M

Epileptogenesis after status epilepticus reflects age- and model-dependent plasticity

Author(s): Sankar R, Shin D, Mazarati AM, Liu H, Katsumori H, et al.

Correlates of behavior problems in children with epilepsy

Author(s): Austin JK, Risinger MW, Beckett LA

Neuropsychological and behavioral status of children with complex partial seizures

Author(s): Schoenfeld J, Seidenberg M, Woodard A, Hecox K, Inglese C, et al.

Behavioural disorders in children with epilepsy: early improvement after surgery

Author(s): Lendt M, Helmstaedter C, Kuczaty S, Schramm J, Elger CE

Recurrent seizures and behavior problems in children with first recognized seizures: a prospective study

Author(s): Austin JK, Dunn DW, Caffrey HM, Perkins SM, Harezlak J, et al.

Landau-Kleffner syndrome: a pharmacologic study of five cases

Author(s): Marescaux C, Hirsch E, Finck S, Maquet P, Schlumberger E, et al.

Efficacy and safety of add-on levetiracetam in refractory childhood epilepsy

Author(s): Kanemura H, Sano F, Tando T, Sugita K, Aihara M