[P2-122] Levetiracetam Monotherapy in Preschool Children with Mild Developmental Disorders and Epilepsy: Short Term Efficacy and Psychotropic Effects.
[Introduction] Although retention rate of the adjunctive levetiracetam (LEV) therapy is generally high, psychiatric side effects were sometimes pointed out, especially in childhood epilepsy with developmental disorders. We report therefore, the short term efficacy and psychotropic effects of LEV monotherapy in preschool children with mild developmental disorders and epilepsy. [Methodology] LEV was started at 15-20 mg/kg/day, and maintained at 30-40 mg/kg/day. Fifteen children (M : F = 9 : 6, mean 5.7 years old, ASD : ADHD : MIX = 6 : 3 : 6) were observed at least 3 months both before and after LEV monotherapy, and evaluated for seizures, EEG (SPI = spike index on EEG), and behavioral changes (ABC-J). [Results] 1) The 50% responder rate (50% RR) was 77% (10 of 13 available patients) and 6 were seizure free. 50% RRs were 87.5% (7/8) for sGTC and 60% (3/5) for CPS. 50% RRs were 80% (4/5) in ASD, 100% (2/2) in ADHD, and 67% (4/6) in MIX. The mean maintenance dose was 32 mg/kg/day, and the mean peak blood concentration was 19.6 ug/ml. Those were not significantly different between effective and ineffective children. 2) SPI improvement (>50% reduction) was observed in 10 children (67%), and was significantly correlated with seizure reduction. 3) Though 4 children had mild somnolence and other one child had transient irritability, but all 15 children continued LEV treatment. Meanwhile, two children experienced improvement of QOL and learning efficiency. [Conclusion] LEV monotherapy could be a favorable therapeutic option for pediatric epilepsy, even with developmental disorders..