Neuropsychological effects of levetiracetam and carbamazepine in children with focal epilepsy
Citation Manager Formats
Make Comment
See Comments
This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Abstract
Objective: To prospectively evaluate the neuropsychological effect of levetiracetam (LVT) in comparison with carbamazepine (CBZ) and its efficacy and tolerability as a monotherapy in children with focal epilepsy.
Methods: A total of 121 out of 135 screened children (4–16 years) were randomly assigned to LVT or CBZ groups in a multicenter, parallel-group, open-label trial. The study's primary endpoints were defined as the end of 52 weeks of treatment, followed by analysis of changes observed in a series of follow-up neurocognitive, behavioral, and emotional function tests performed during treatment in the per protocol population. Drug efficacy and tolerability were also analyzed among the intention-to-treat (ITT) population (ClinicalTrials.gov, number NCT02208492).
Results: Eighty-one patients (41 LVT, 40 CBZ) from the randomly assigned ITT population of 121 children (57 LVT, 64 CBZ) were followed up to their last visit. No significant worsening or differences were noted between groups in neuropsychological tests, except for the Children's Depression Inventory (LVT −1.97 vs CBZ +1.43, p = 0.027, [+] improvement of function). LVT-treated patients showed an improvement (p = 0.004) in internalizing behavioral problems on the Korean Child Behavior Checklist. Seizure-free outcomes were not different between the 2 groups (CBZ 57.8% vs LVT 66.7%, p = 0.317).
Conclusions: Neither LVT nor CBZ adversely affected neuropsychological function in pediatric patients. Both medications were considered equally safe and effective as monotherapy in children with focal epilepsy.
Classification of evidence: This study provides Class II evidence that in patients with pediatric focal epilepsy, LVT and CBZ exhibit equivalent effects on neuropsychological function.
GLOSSARY
- AED=
- antiepileptic drug;
- CBZ=
- carbamazepine;
- CDI=
- Children's Depression Inventory;
- FDA=
- Food and Drug Administration;
- FSIQ=
- full-scale intelligence quotient;
- ILAE=
- International League Against Epilepsy;
- ITT=
- intention-to-treat;
- K-CBCL=
- Korean Child Behavior Checklist;
- K-WIPSSI-III=
- Korean Wechsler Preschool and Primary Scale of Intelligence–third edition;
- K-WISC-III=
- Korean Wechsler Intelligence Scale for Children–third edition;
- LVT=
- levetiracetam;
- PIQ=
- performance intelligence quotient;
- PP=
- per protocol;
- RCMAS=
- Revised Children's Manifest Anxiety Scale;
- VIQ=
- verbal intelligence quotient
Footnotes
↵* These authors contributed equally to this work and are co-first authors.
Presented as a poster and received the best poster award at the 10th Asian & Oceanian Epilepsy Congress, Singapore, August 7–10, 2014.
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Editorial, page 2298
Supplemental data at Neurology.org
- Received October 7, 2014.
- Accepted in final form January 12, 2015.
- © 2015 American Academy of Neurology
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
For assistance, please contact:
AAN Members (800) 879-1960 or (612) 928-6000 (International)
Non-AAN Member subscribers (800) 638-3030 or (301) 223-2300 option 3, select 1 (international)
Sign Up
Information on how to subscribe to Neurology and Neurology: Clinical Practice can be found here
Purchase
Individual access to articles is available through the Add to Cart option on the article page. Access for 1 day (from the computer you are currently using) is US$ 39.00. Pay-per-view content is for the use of the payee only, and content may not be further distributed by print or electronic means. The payee may view, download, and/or print the article for his/her personal, scholarly, research, and educational use. Distributing copies (electronic or otherwise) of the article is not allowed.
Letters: Rapid online correspondence
REQUIREMENTS
You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
You May Also be Interested in
Dr. Ann Yeh and Dr. Daniela Castillo Villagrán
► Watch
Related Articles
Topics Discussed
Alert Me
Recommended articles
-
Articles
Comparison of levetiracetam and controlled-release carbamazepine in newly diagnosed epilepsyM. J. Brodie, E. Perucca, P. Ryvlin et al.Neurology, February 05, 2007 -
Articles
Placebo-controlled study of levetiracetam in idiopathic generalized epilepsyS. F. Berkovic, R. C. Knowlton, R. F. Leroy et al.Neurology, July 11, 2007 -
Articles
Double-blind placebo-controlled trial of adjunctive levetiracetam in pediatric partial seizuresT. A. Glauser, R. Ayala, R. D. Elterman et al.Neurology, April 26, 2006 -
Articles
Levetiracetam for the treatment of idiopathic generalized epilepsy with myoclonic seizuresS. Noachtar, E. Andermann, P. Meyvisch et al.Neurology, February 19, 2008