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. 2018 Jun 15;44(1):70.
doi: 10.1186/s13052-018-0507-8.

Intermittent oral levetiracetam reduced recurrence of febrile seizure accompanied with epileptiform discharge: a pilot study

Lin-Yan Hu  1 , Xiu-Yu Shi  1 , Hui Li  1 , Meng-Na Zhang  1 , Shu-Fang Ma  1 , Li-Ping Zou  2
Affiliations

Intermittent oral levetiracetam reduced recurrence of febrile seizure accompanied with epileptiform discharge: a pilot study

Lin-Yan Hu et al. Ital J Pediatr. .

Abstract

Background: In previous study, we have found intermittent oral levetiracetam (LEV) can effectively prevent recurrence of febrile seizure (FS). This study aimed to analyze the effects of the preventive on the patients with frequent FS accompanied with epileptiform discharge.

Methods: Patients with frequent FS were assigned to undergo Electroencephalogram (EEG). At the onset of fever, the patients who presented epileptiform discharge were orally administered with LEV with a dose of 15-30 mg/kg per day twice daily for 1 week, thereafter, the dosage was gradually reduced until totally discontinued in the second week. The seizure frequency associated with febrile events and FS recurrence rate during a 48-week follow-up were analyzed.

Results: among the 19 patients presented epileptiform discharge on EEG, 31.58% (6 of 19) had complex FS, 68.42% (13 of 19) had simple FS. Up to 57.89% (11 of 19) had a family history of seizure disorder and 36.84% (7 of 19) had a family history of FS in first-degree relatives. 42.11% (8 of 19) happened the first FS episode at the age < 18 months. 36.84% (7/19) presented generalized spikes, 63.16% (12/19) showed focal spikes. During the 48-week follow-up period, the patients experienced 26 febrile episodes, none of them presented seizure recurrence.

Conclusion: Intermittent oral LEV can prevent the seizure recurrence of FS accompanied with epileptiform discharge in 48-week. However, further randomized controlled trials should be conducted.

Trial registration: ChiCTR-IPR-15007241 ; Registered 1 January 2014 - Retrospectively registered.

Keywords: Children; Electroencephalogram; Epileptiform discharge; Febrile seizure; Levetiracetam.

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Conflict of interest statement

Ethics approval and consent to participate

The present research was conducted in accordance with the Declaration of Helsinki and approved by the ethics committee of Chinese PLA General Hospital.

Consent for publication

The written informed consent was obtained from the parent/caregiver of each child before trial-related procedures were performed.

Competing interests

The authors declare that they have no competing interests. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Classification of foci of epileptiform discharges: Among the 19 patients with epileptiform discharges on EEG, 7 (36.84%) presented generalized spikes, and 12 (63.16%) showed focal spikes, of which 5 patients (26.32%) had epileptiform discharges from the frontal area, 3 (15.79%) from the fronto-central area, 1 (5.26%) from the central area, 1 (5.26%) from the centro-parietal area, 1 (5.26%) from the fronto-centro-temporal area, and 1 (5.26%) from the parieto-occipito-temporal area
Fig. 2
Fig. 2
The EEG characteristic of one patient: paroxysmal 3-4 Hz spike-and-waves, slow waves were presented in all leads, especially in frontal area
See this image and copyright information in PMC

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