HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Correspondence: Submit a response Correspondence: View responses Alert me when this article is cited Alert me when Correspondence are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Milligan, T. A. Articles by Bromfield, E. B. Search for Related Content PubMed Articles by Milligan, T. A. Articles by Bromfield, E. B. Related Collections All Epilepsy/Seizures Antiepileptic drugs

Efficacy and tolerability of levetiracetam versus phenytoin after supratentorial neurosurgery

From the Departments of Neurology (T.A.M., E.B.B.) and Medicine (S.H.), Brigham & Women's Hospital, Boston, MA.

Address correspondence and reprint requests to Dr. Tracey A. Milligan, Department of Neurology, Department of Medicine, Brigham & Women's Hospital, 75 Francis St., Boston, MA 02115 tmilligan{at}partners.org

Background: Antiepileptic drugs are routinely given after craniotomy. Though phenytoin (PHT) is still the most commonly used agent, levetiracetam (LEV) is increasingly administered for this purpose. This retrospective study compared the use of LEV and PHT as monotherapy prophylaxis following supratentorial neurosurgery.

Methods: Patients receiving LEV monotherapy after supratentorial craniotomy were reviewed and compared to a control group of patients receiving PHT monotherapy.

Results: One of 105 patients taking LEV and 9/210 patients taking PHT had seizures within 7 days of surgery (p = 0.17). Adverse drug reactions requiring change in therapy during hospitalization occurred in 1/105 patients taking LEV and 38/210 patients taking PHT (p < 0.001). Among patients followed for at least 12 months, 11/42 (26%) treated with LEV vs 42/117 (36%) treated with PHT developed epilepsy (p = 0.34); 64% remained on LEV, while 26% remained on PHT (p = 0.03).

Conclusions: Both levetiracetam (LEV) and phenytoin (PHT) were associated with a low risk of early postoperative seizures and a moderate risk of later epilepsy. LEV was associated with significantly fewer early adverse reactions than PHT and with a higher retention rate in patients who were followed for at least 1 year and developed epilepsy.

Abbreviations: ADR = adverse drug reaction; AED = antiepileptic drug; CBZ = carbamazepine; LEV = levetiracetam; PB = phenobarbital; PHT = phenytoin; VPA = valproate.

Received September 23, 2007. Accepted in final form May 23, 2008.

Disclosure: This study was funded by a UCB young investigator's award. T.A.M. and E.B.B. have received honoraria and/or consulting fees totaling less than $10,000 from UCB.

This article has been cited by other articles:

				J. W. Lee, E. B. Bromfield, and S. Kesari Antiemetic Properties of the Antiepileptic Drug Levetiracetam N. Engl. J. Med., October 23, 2008; 359(17): 1853 - 1853. [Full Text] [PDF]

Correspondence: