A Cochrane review included 2 studies with a total of 296 children (age range 4-16 years). They had drug-resistant focal epilepsy with seizures despite of at least one concomitant antiepileptic drug. The levetiracetam dose was 60 mg/kg/day and treatment ranged from 12 to 24 weeks. NNT for an additional beneficial outcome for children was 4 (95% CI 3-7). The RR for at least 50% reduction in focal seizure frequency was 1.91 (95% CI 1.38-2.63), with an RR of 0.68 (95% CI 0.56-0.81) for non-response. A total of 27% of children responded. They were not significantly more likely to have levetiracetam withdrawn (RR 0.80; 95% CI 0.43-1.46). No individual adverse effect was significantly associated with levetiracetam. However, changes in behaviour were significant (23% affected; RR 1.90; 99% CI 1.16-3.11). Levetiracetam did not appear to alter cognitive function but there was evidence of worsening in certain aspects of behaviour.
Comment: The quality of evidence is downgraded by study quality (short follow-up time) and imprecise results (limited study size for each comparison).
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