www.clinicaltrials.gov registration number: NCT01463033.
Results of phase II levetiracetam trial following acute head injury in children at risk for posttraumatic epilepsy
Article first published online: 22 JUL 2013
Wiley Periodicals, Inc. © 2013 International League Against Epilepsy
Volume 54, Issue 9, pages e135–e137, September 2013
How to Cite
Pearl, P. L., McCarter, R., McGavin, C. L., Yu, Y., Sandoval, F., Trzcinski, S., Atabaki, S. M., Tsuchida, T., van den Anker, J., He, J. and Klein, P. (2013), Results of phase II levetiracetam trial following acute head injury in children at risk for posttraumatic epilepsy. Epilepsia, 54: e135–e137. doi: 10.1111/epi.12326
- Issue published online: 6 SEP 2013
- Article first published online: 22 JUL 2013
- Manuscript Accepted: 18 JUN 2013
- NIH. Grant Number: R01 NS45656
- GCRC of Children's National Medical Center
- UCB Pharma, Inc
- Posttraumatic epilepsy;
Posttraumatic seizures develop in up to 20% of children following severe traumatic brain injury (TBI). Children ages 6–17 years with one or more risk factors for the development of posttraumatic epilepsy, including presence of intracranial hemorrhage, depressed skull fracture, penetrating injury, or occurrence of posttraumatic seizure were recruited into this phase II study. Treatment subjects received levetiracetam 55 mg/kg/day, b.i.d., for 30 days, starting within 8 h postinjury. The recruitment goal was 20 treated patients. Twenty patients who presented within 8–24 h post-TBI and otherwise met eligibility criteria were recruited for observation. Follow-up was for 2 years. Forty-five patients screened within 8 h of head injury met eligibility criteria and 20 were recruited into the treatment arm. The most common risk factor present for pediatric inclusion following TBI was an immediate seizure. Medication compliance was 95%. No patients died; 19 of 20 treatment patients were retained and one observation patient was lost to follow-up. The most common severe adverse events in treatment subjects were headache, fatigue, drowsiness, and irritability. There was no higher incidence of infection, mood changes, or behavior problems among treatment subjects compared to observation subjects. Only 1 (2.5%) of 40 subjects developed posttraumatic epilepsy (defined as seizures >7 days after trauma). This study demonstrates the feasibility of a pediatric posttraumatic epilepsy prevention study in an at-risk traumatic brain injury population. Levetiracetam was safe and well tolerated in this population. This study sets the stage for implementation of a prospective study to prevent posttraumatic epilepsy in an at-risk population.