1.中国人民解放军总医院 儿童医学中心，北京 100853；2.江西省儿童医院 神经内科，南昌 330006； 3.首都医科大学附属北京儿童医院 神经内科，北京 100045；4.重庆医科大学附属儿童医院 神经康复科，重庆 400014；5.北京新世纪儿童医院 儿科，北京 100045；6.Departments of Medicine and Neurology, Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia；7.Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong , China
Febrile seizure recurrence reduced by intermittent oral levetiracetam
1.Department of Pediatrics, Chinese PLA General Hospital, Beijing 100583, China; 2. Department of Neurology, Jiang-Xi Children's Hospital, Nanchang 330006, China; 3. Department of Neurology, Beijing Children’s Hospital, Beijing 100045, China; 4. Department of Neurology, Children's Hospital of Chongqing Medical University, Chongqing 400014, China; 5. The Beijing New Century Children's Hospital, Beijing 100045, China; 6. Departments of Medicine and Neurology, Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia;7 Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, China
Abstract: Objective Febrile seizure (FS) is the most common form of children seizure disorders. FS is perhaps one of the most frequent causes of admittance to pediatric emergency wards worldwide. We aimed to identify a new, safe, and effective therapy for preventing FS recurrence. Method A total of 115 children with a history of two or more episodes of FS were randomly assigned to levetiracetam (LEV) and control (LEV/control ratio = 2:1) groups. At the onset of fever, LEV group was orally administered 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 primary efficacy variable was seizure frequency associated with febrile events and FS recurrence rate (RR) during 48-weeks follow-up. The second outcome was the cost effectiveness of the two groups. Results The intention-to-treat analysis showed that 78 children in LEV group experienced 148 febrile episodes. Among these 78 children, 11 experienced 15 FS recurrences. In control group, 37 children experienced 64 febrile episodes; among these 37 children, 19 experienced 32 FS recurrences. A significant difference was observed between two groups in FS RR and FS recurrence/fever episode. The cost of LEV group for the prevention of FS recurrence is lower than control group. During 48-week follow-up period, one patient in LEV group exhibited severe drowsiness. No other side effects were observed in the same patient and in other children. Conclusions Intermittent oral LEV can effectively prevent FS recurrence and reduce wastage of medical resources
2015, Vol. 3 
