Clinical features of long-term low-dose levetiracetam treatment for epilepsy

BackgroundThe aim of this study was to assess the rate of response to long-term low-dose levetiracetam (LEV) treatment and the clinical factors associated with response. MethodsThe response to low-dose LEV of 43 patients with epilepsy (22 male, 21 female; age range, 5-39 years; median age, 13years) was retrospectively assessed. Patients aged <15years received <20mg/kg/day LEV, whereas those aged 15years received <1000mg/day LEV. Clinical features were compared between responders to low-dose LEV, responders to the recommended dose, and non-responders. ResultsOf the 43 patients who received low-dose LEV, 13 (30%) showed improvement, defined as seizure cessation or >75% seizure reduction over 6months for patients with monthly, weekly, and daily seizures; and over 1year for patients with yearly seizures. Efficacy was maintained for >1year in 10 (77%) of the 13 patients. Long-term response to low-dose LEV was significantly associated with older age at onset and fewer previous treatments with ineffective anti-epileptic drugs. All patients showing long-term response to low-dose LEV developed only focal seizures. ConclusionsTitration of LEV starting from a low dose may be effective in selected patients. Once patients respond to low-dose treatment, maintenance of the effective dosage may prolong response.