Epilepsy Unit, Neurology Department, Vall d'Hebron University Hospital, Barcelona, Spain.
Epilepsy Research Group, Vall d'Hebron Research Institute (VHIR, Barcelona, Spain.
Acta Neurol Scand. 2021 Apr;143(4):407-412. doi: 10.1111/ane.13389. Epub 2021 Jan 15.
Levetiracetam (LEV) is effective in Idiopathic Generalized Epilepsy (IGE) and seems to be a good alternative to valproic acid in women of childbearing age. However, there is lack of approval for this indication as monotherapy. The aim of this study is to assess the efficacy of LEV as a first-line therapy in this population.
The study is a descriptive analysis of women aged between 16 and 45 years old diagnosed with IGE and treated with LEV as first-line monotherapy. Minimum follow-up was 24 months.
26 women. Mean age: 25.4 years (17-43). 14 Juvenile Myoclonic Epilepsy; 8 Tonic-Clonic Seizures Alone; 4 Juvenile Absence. Mean follow-up: 68.3 months (24-120). 11 patients (40.7%) continued to take LEV as monotherapy, of which 10 were seizure-free, and three (11.5%) continue to be seizure-free after withdrawing LEV. 12 patients (46.2%) required a change of treatment: 25% (3/12) due to lack of efficacy, 42% (5/12) due to adverse effects and 33% (4/12) due to both. Irritability was the most frequent adverse effect. At the last assessment, three patients (11.5%) continued to have seizures despite polytherapy. Estimated retention rates were 78.1% at one year (SE 7.3%) and 51% at 5 years (SE 9.8%). Estimated median retention time is 72 months (CI 95%: 50.9-93.1).
LEV could be an effective drug as first-line treatment for IGE in women of childbearing potential. The adverse effects are its main limitation. Comparative studies are needed in order to establish it for this indication.
左乙拉西坦（LEV）在特发性全面性癫痫（IGE）中有效，似乎是育龄妇女丙戊酸的良好替代品。然而，作为单一疗法，它尚未获得批准。本研究旨在评估 LEV 在该人群中作为一线治疗的疗效。
这是一项对诊断为 IGE 并接受 LEV 一线单药治疗的 16-45 岁女性的描述性分析。最低随访时间为 24 个月。
26 名女性。平均年龄：25.4 岁（17-43 岁）。14 例青少年肌阵挛性癫痫；8 例单纯强直阵挛发作；4 例青少年失神。平均随访时间：68.3 个月（24-120）。11 名患者（40.7%）继续接受 LEV 单药治疗，其中 10 名患者无癫痫发作，3 名（11.5%）在停用 LEV 后仍无癫痫发作。12 名患者（46.2%）需要更换治疗方案：25%（3/12）因疗效不佳，42%（5/12）因不良反应，33%（4/12）因两者兼有。烦躁是最常见的不良反应。最后一次评估时，尽管进行了多药治疗，仍有 3 名患者（11.5%）仍有癫痫发作。一年时的估计保留率为 78.1%（SE 7.3%），五年时为 51%（SE 9.8%）。估计中位保留时间为 72 个月（95%CI：50.9-93.1）。
LEV 可能是育龄妇女 IGE 的有效一线治疗药物。其主要限制是不良反应。需要进行比较研究以确定其在该适应证中的地位。
