Objective: To evaluate the efficacy and safety of levetiracetam in the management of epilepsy in patients with glioma.
Design: A prospective study in hospitalized patients with a new diagnosis of glioma.
Setting: Department of Neurological Sciences and Visions, Spedali Civili of Brescia.
Patients: From March 1, 2006, until January 1, 2009, 176 consecutive patients (101 men and 75 women) with a first diagnosis of glioma were enrolled in the study. All patients with a diagnosis of epilepsy were treated with levetiracetam.
Main outcome measures: Clinical, histological, and magnetic resonance imaging findings were analyzed.
Results: Age at the diagnosis of glioma ranged from 22 to 79 years (mean [SD], 57 [15] years; median, 59 years). Duration of the disease ranged from 27 days to 2(1/2) years (mean [SD], 13.7 [7.8] months; median, 13 months). Eighty-two patients received levetiracetam because of a diagnosis of epilepsy. At the last evaluation (May 1, 2009), 75 of 82 patients (91%) treated with levetiracetam were seizure free; in 2 of these patients, levetiracetam was withdrawn because of intolerable adverse effects. Prompt and long-lasting control of seizures was obtained in 49 of 82 patients (60%) with a dose of levetiracetam that ranged from 1500 to 3000 mg/d, and 9 (11%) of the treated patients needed an increase of levetiracetam dosage to 4000 mg/d to become seizure free. No laboratory abnormalities were observed in patients with concomitant chemotherapy.
Conclusion: The results of this study provide good evidence that levetiracetam is efficacious and safe in patients with epilepsy due to glioma.