Effects of levetiracetam on EEG abnormalities in juvenile myoclonic epilepsy

Epilepsia. 2008 Apr;49(4):663-9. doi: 10.1111/j.1528-1167.2007.01523.x. Epub 2008 Feb 5.


Purpose: A multicenter, prospective, long-term, open-label study to evaluate the effects of levetiracetam on electroencephalogram (EEG) abnormalities and photoparoxysmal response (PPR) of patients affected by juvenile myoclonic epilepsy (JME).

Methods: Forty-eight patients with newly diagnosed JME (10) or resistant/intolerant (38) to previous antiepileptic drugs (AEDs) were enrolled. After an 8-week baseline period, levetiracetam was titrated in 2 weeks to 500 mg b.i.d. and then increased to up to 3,000 mg/day. Efficacy parameters were based on the comparison and analysis of EEG interictal abnormalities classified as spikes-and-waves, polyspikes-and-waves, and presence of PPR. Secondary end point was evaluation of EEG and PPR changes as predictive factors of 12-month seizure freedom.

Results: Overall, mean dose of levetiracetam was 2,208 mg/day. Mean study period was 19.3 +/- 11.5 months (range 0.3-38). During the baseline period, interictal EEG abnormalities were detected in 44/48 patients (91.6%) and PPR was determined in 17/48 (35.4%) of patients. After levetiracetam treatment, 27/48 (56.2%) of patients compared to 4/48 (8.3%) in the baseline period (p < 0.0001) had a normal EEG. Thirteen of 17 (76.4%) (p < 0.0003) patients showed suppression of PPR. Cumulative probability of days with myoclonia (DWM) 12-month remission was significantly higher (p < 0.05) in patients with a normal (normalized) EEG after levetiracetam treatment compared to those with an unchanged EEG.

Conclusions: Levetiracetam appeared to be effective in decreasing epileptiform EEG abnormalities, and suppressing the PPR in JME patients. This effect, along with a good efficacy and tolerability profile in this population further supports a first-line role for levetiracetam in the treatment of JME.

Publication types

  • Clinical Trial
  • Comparative Study
  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Age of Onset
  • Anticonvulsants / pharmacology
  • Anticonvulsants / therapeutic use*
  • Dose-Response Relationship, Drug
  • Drug Resistance
  • Electroencephalography / drug effects*
  • Electroencephalography / statistics & numerical data
  • Epilepsy, Reflex / diagnosis
  • Epilepsy, Reflex / drug therapy
  • Epilepsy, Reflex / prevention & control
  • Female
  • Follow-Up Studies
  • Humans
  • Levetiracetam
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Myoclonic Epilepsy, Juvenile / diagnosis
  • Myoclonic Epilepsy, Juvenile / drug therapy*
  • Photic Stimulation
  • Piracetam / analogs & derivatives*
  • Piracetam / pharmacology
  • Piracetam / therapeutic use
  • Prospective Studies
  • Time Factors
  • Treatment Outcome


  • Anticonvulsants
  • Levetiracetam
  • Piracetam