The quality of evidence is downgraded by imprecise results (few patients and outcome events).
A Cochrane review [Abstract] 1 included 2 studies with a total of 296 children (age range 4-16 years). They had drug-resistant focal epilepsy with seizures despite of at least one concomitant antiepileptic drug. The levetiracetam dose was 60 mg/kg/day and treatment ranged from 12 to 24 weeks. The RR for at least 50% reduction in focal seizure frequency was 1.91 (95% CI 1.38 to 2.63). 52% of children responded to levetiracetam (95% CI 44% to 59%), with a placebo response of 25% (95% CI 18% to 34%). They were not significantly more likely to have levetiracetam withdrawn (RR 0.80; 95% CI 0.43 to 1.46). No individual adverse effect was significantly associated with levetiracetam. However, changes in behaviour were significant (23% affected; RR 1.90; 99% CI 1.16 to 3.11). Levetiracetam did not appear to alter cognitive function but there was evidence of worsening in certain aspects of behaviour.
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