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Neuropsychological effects of levetiracetam and carbamazepine in children with focal epilepsy

Authors
 Da Eun Jung  ;  Rita Yu  ;  Jung-Rim Yoon  ;  Baik-Lin Eun  ;  Soon Hak Kwon  ;  Yun Jin Lee  ;  So-Hee Eun  ;  Joon Soo Lee  ;  Heung Dong Kim  ;  Sang Ook Nam  ;  Gun-Ha Kim  ;  Su-Kyeong Hwang  ;  Soyong Eom  ;  Dae Ryong Kang  ;  Hoon-Chul Kang 
Citation
 NEUROLOGY, Vol.84(23) : 2312-2319, 2015 
Journal Title
 NEUROLOGY 
ISSN
 0028-3878 
Issue Date
2015
MeSH
Adolescent ; Anticonvulsants/administration & dosage ; Anticonvulsants/adverse effects ; Anticonvulsants/pharmacology* ; Carbamazepine/administration & dosage ; Carbamazepine/adverse effects ; Carbamazepine/pharmacology* ; Child ; Child Behavior/drug effects* ; Child, Preschool ; Epilepsies, Partial/drug therapy* ; Female ; Follow-Up Studies ; Humans ; Intelligence/drug effects* ; Male ; Piracetam/administration & dosage ; Piracetam/adverse effects ; Piracetam/analogs & derivatives* ; Piracetam/pharmacology ; Social Skills* ; Treatment Outcome
Abstract
OBJECTIVE: To prospectively evaluate the neuropsychological effect of levetiracetam (LVT) in comparison with carbamazepine (CBZ) and its efficacy and tolerability as a monotherapy in children with focal epilepsy. METHODS: A total of 121 out of 135 screened children (4-16 years) were randomly assigned to LVT or CBZ groups in a multicenter, parallel-group, open-label trial. The study's primary endpoints were defined as the end of 52 weeks of treatment, followed by analysis of changes observed in a series of follow-up neurocognitive, behavioral, and emotional function tests performed during treatment in the per protocol population. Drug efficacy and tolerability were also analyzed among the intention-to-treat (ITT) population (ClinicalTrials.gov, number NCT02208492). RESULTS: Eighty-one patients (41 LVT, 40 CBZ) from the randomly assigned ITT population of 121 children (57 LVT, 64 CBZ) were followed up to their last visit. No significant worsening or differences were noted between groups in neuropsychological tests, except for the Children's Depression Inventory (LVT -1.97 vs CBZ +1.43, p = 0.027, [+] improvement of function). LVT-treated patients showed an improvement (p = 0.004) in internalizing behavioral problems on the Korean Child Behavior Checklist. Seizure-free outcomes were not different between the 2 groups (CBZ 57.8% vs LVT 66.7%, p = 0.317). CONCLUSIONS: Neither LVT nor CBZ adversely affected neuropsychological function in pediatric patients. Both medications were considered equally safe and effective as monotherapy in children with focal epilepsy. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that in patients with pediatric focal epilepsy, LVT and CBZ exhibit equivalent effects on neuropsychological function.
Full Text
http://www.neurology.org/content/84/23/2312.abstract
DOI
10.1212/WNL.0000000000001661
Appears in Collections:
5. Research Institutes (연구소) > Epilepsy Research Institute (뇌전증연구소) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Hoon Chul(강훈철) ORCID logo https://orcid.org/0000-0002-3659-8847
Kim, Heung Dong(김흥동) ORCID logo https://orcid.org/0000-0002-8031-7336
Eom, So Yong(엄소용)
Yu, Rita(유리타미영)
Yoon, Jung Rim(윤정림)
Lee, Joon Soo(이준수) ORCID logo https://orcid.org/0000-0001-9036-9343
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/140312
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