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Epilepsy Drug Succeeds Where Others Fail

Keppra eases seizures in children with otherwise uncontrollable symptoms

SATURDAY, Jan. 11, 2003 (HealthDayNews) -- Any parent can relate to the agony of watching a child suffer severe epileptic seizures because there's no medicine that works, but there is hope on the horizon.

A recent study shows the drug Keppra can relieve seizures in some children who were not helped by other treatments.

Researchers tested Keppra, an epilepsy drug currently approved by the U.S. Food and Drug Administration for use in adults, in 39 children ranging in age from infancy to 14 who had hard-to-control seizures.

They found Keppra reduced seizures by 50 percent in one-third of the children. Seizures stopped completely for three children and nine children had a more than 90 percent reduction in seizures.

"Cleary this is a medicine that has a role in treating childhood epilepsy," says study author Dr. James W. Wheless, director of the Texas Comprehensive Epilepsy Program at the University of Texas Medical School at Houston. "Overall, it was a drug that had a very nice safety profile."

The study was published in a recent issue of the Journal of Child Neurology. Studies involving larger numbers of children are ongoing, Wheless says, and that data should be ready for analysis early this year.

Epilepsy is a brain disorder in which neurons periodically produce sudden bursts of electrical energy that disrupt other brain functions. The frenzied neural discharges can cause symptoms ranging from strange sensations and emotions to convulsions, muscle spasms and loss of consciousness. Roughly 300,000 U.S. children have the disorder, and those who have refractory epilepsy have seizures that are so severe and so frequent that traditional medications don't work.

"The patients in this study have basically run out of treatment options, so it's encouraging that Keppra was effective and controlled seizures in 30 percent of our patients," Wheless says.

For most epileptics, symptoms come on with little or no warning, says Dr. Gregory Barkley, medical advisor to the Epilepsy Foundation. They have to worry if they'll have a seizure while driving, or during a business meeting, or while caring for their children.

"Imagine if at some point today, for one minute and without warning, you suddenly couldn't remember what you were thinking about, stared blankly and fell to the ground," Barkley says. "People with epilepsy have that hanging over them like the sword of Damocles all the time."

Heavy doses of anti-seizure medications can control seizures in many patients -- but not all. About one-fourth of patients still suffer occasional or frequent bouts, Barkley says.

And even the rare seizure can significantly disrupt life -- most states require a person to be seizure-free for at least six months to drive.

"Even with all the advances we've made, there are still hundreds of thousands of people with epilepsy whose seizures are not controlled by current medication," Wheless says.

Keppra, the brand name for levetiracetam, was approved about three years ago for use in adults. While doctors do prescribe it for children, they aren't sure of the safest and most effective dosages, particularly because many children with epilepsy are taking multiple medications, Wheless explains.

"Although Keppra is not currently approved for use in children, we wanted to study Keppra because it has a favorable efficacy, a lack of drug interactions, ease of use and is well-tolerated," he says.

The current study showed the drug has about the same rate of success in children as in adults, he adds. About one quarter of parents also reported improvement in their child's behavior and cognition.

Epilepsy doesn't necessarily cause problems with cognition or behavior, Barkley says. However, because it's a disorder of the brain, epilepsy can affect all sorts of brain functions. In addition, high dosages of epilepsy medications can cause side effects that affect thinking and behavior.

About 10 percent of parents reported their children were more irritable and aggressive while taking Keppra. These symptoms disappeared shortly after the dosage was lowered or stopped.

"What makes Keppra an attractive drug is that it is often very effective, it's simple to use, doses are effective within a few days and most people do not complain of many side effects," Barkley says. "This drug has shown its benefit in many patients who were not helped by other drugs."

More information

For more information about epilepsy and treatments, visit the Epilepsy Foundation or the National Institute of Neurological Disorders and Stroke.

SOURCES: James W. Wheless, M.D., director, Texas Comprehensive Epilepsy Program, University of Texas Medical School, Houston; Gregory Barkley, M.D., medical director, Henry Ford Comprehensive Epilepsy Center, Detroit; August 2002 Journal of Child Neurology
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