NEUROPSYCHOLOGICAL CHANGE ASSOCIATED WITH THE ADDITION OF LEVETIRACETAM (KEPPRA) WHEN TREATING PEDIATRIC EPILEPSY

Objectives: Children with epilepsy are often treated with multiple medications to control seizures. Polypharmacy is associated with a negative impact on behavior and cognition, contributing to psychosocial morbidity. Keppra is a recent addition to epilepsy treatment. Research with adults suggests it does not contribute adversely to cognition. This study examined whether changes in functioning accompany the addition of Keppra. Controlling for impact of epilepsy and medication, we examined the impact Keppra had on cognition and behavior. Methods: 13 patients, aged 7–17, participated. All were diagnosed with complex partial epilepsy nonresponsive to single drug intervention. Assessment of current functioning, following at least one month treatmentwith Keppra was conducted. Participants were administered tests of language, attention, memory, visuospatial processing, executive functioning, and behavior regulation. School performance records were obtained. Each subject served as a case control, allowing for examination of changes in performance, to identify a possible additive impact of Keppra.

Results: The addition of Keppra contributed to no decrement in neurocognitive functioning. Positive changes in attention and memory were observed for a majority (n=10) of patients. Positive behavioral changes were also reported. The addition of Keppra did possibly lead to increased seizure activity in 3 children. The majority of patients showed a positive effect from the addition of Keppra, in terms of seizure control and neurocognitive functioning.

Conclusion: Retrospective analysis of 13 pediatric epilepsy patients, serving as their own controls, highlighted a predominantly positive impact for the addition of Keppra. Importantly, some patients showed improvement in seizure control, attention, and memory functions.