Comparison of Levetiracetam Versus Sodium Valproate as a Monotherapy in Early Childhood Epilepsy.

BACKGROUND

Childhood epilepsy requires long-term management with antiepileptic drugs (AEDs) that are both effective and well-tolerated. Although levetiracetam and sodium valproate are widely used as monotherapies, comparative data on their efficacy and safety in pediatric populations are limited. This study aimed to evaluate and compare their effectiveness and tolerability in children with epilepsy over six months.

METHODS

A randomized controlled study was conducted involving 200 children aged 3 to 12 years with generalized or focal epilepsy. They were randomly assigned to receive either levetiracetam (n=100) or sodium valproate (n=100), and received sodium valproate at an initial dose of 30 mg/kg/day. Efficacy was defined as a threefold increase in seizure-free interval. Side effects were monitored monthly. Data were analyzed using SPSS version 29 with a significance threshold of p<0.05.

RESULTS

Seizure control was achieved in 85% of children in the levetiracetam group and 73% in the sodium valproate group (p=0.037). Absence of side effects was reported in 31% of the levetiracetam group and 10% of the sodium valproate group (p=0.012). Weight gain occurred in 16 children (16.0%) in the sodium valproate group versus 5 children (5.0%) in the levetiracetam group. Other side effects, including hepatotoxicity, rash, somnolence, tremors, and behavioral changes, were comparable between the groups.

CONCLUSION

Levetiracetam appears to be more effective and better tolerated than sodium valproate for the management of pediatric epilepsy. These findings suggest that levetiracetam could be considered a preferred first-line monotherapy. However, further longitudinal studies are warranted to validate these outcomes over longer treatment durations.