Use of levetiracetam monotherapy in patients with post-traumatic epilepsy: preliminary data

Rationale: The aimof this studywas to evaluate efficacy and tolerability of levetiracetam (LEV) monotherapy in patients with post-traumatic epilepsy. Methods: Six patients with post-traumatic epilepsy entered the study.All presented complex partial seizures, with secondary generalization in 3 cases. At study enter 3 patients were already treated with antiepileptic drugs (AEDs): these patients were seizure free but all reported severe side effects related to AED treatment. The remaining 3 patients were not treated at study entry: two of them had received AEDs in the past, but had discontinued treatment because of side effects, while the last one was a 70-year old man who had never been treated with AEDs and who reported also severe memory disturbances after the trauma. These 3 patients still presented seizures. LEV was initially given as add on therapy in the 3 treated patients: concomitant AED treatment was slowly withdrawn in the following months and the patients were left on LEV monotherapy. The 3 untreated patients received LEV in monotherapy since the beginning. Follow up with LEV monotherapy was at least 12 months in all patients. Results: In the 3 patients who were already seizure free, switch from previous AED treatment to LEV monotherapy was accompanied by persisting complete control of seizures; side effects related to previous AED treatment disappeared with relevant improvement of quality of life. In the 3 untreated patients LEV resulted in complete seizure control without side effects. The elderly patient showed also a considerable improvement of memory disturbances, possibly related to control of infraclinic seizures. Conclusions: In our small series LEV was effective in treating post- traumatic seizures, showing also a good tolerability without adverse effects on memory, behaviour and cognitive state. This is particularly important since memory disturbances and cognitive impairment are frequent after severe head trauma