Levetiracetam and therapy of epilepsy in specific clinical situations
Klinika Neurologii i Epileptologii z Oddziałem Udarowym Uniwersyteckiego Szpitala Klinicznego im. WAM, Uniwersytet Medyczny w Łodzi
AKTUALN NEUROL 2013, 13 (4), p. 258–266

Epilepsy is a chronic, frequently encountered neurological disease, demanding long-term treatment with antiepileptic drugs (AEDs). It involves high treatment expenses. Epilepsy is a complex pathophysiological process, the numerous and complex symptoms are the result of various disorders of the brain. In the treatment of epilepsy, there is no one standard way to proceed. The main and primary goal of epilepsy treatment is complete seizure control and getting the least side effects during treatment with antiepileptic drugs. It is vital that individual adjustment of the drug for each patient. The drug should be adapted to the type of seizure or seizure team, the frequency and severity of seizures. The emergence of a new generation of drugs gave them a certain advantage over the oldergeneration drugs. Levetiracetam is one of the antiepileptic drugs – the pharmacokinetic profile of levetiracetam has been evaluated in many populations. Overall, levetiracetam has a very favourable pharmacokinetic profile, with rapid absorption following oral administration, excellent bioavailability, quick achievement of steady-state concentrations, linear kinetics, minimal plasma protein binding and without important hepatic metabolism. The mechanism of actions is still unclear. It may be used as monotherapy in patients with newly diagnosed epilepsy, to treat seizures with focal onset with secondary generalization or without secondary generalization. Levetiracetam may also be used supplementary to other antiepileptic drugs in the treatment of seizures of focal onset with secondary generalization or without secondary generalization, myoclonic seizures or primary generalized tonic-clonic seizure. This medicine is very useful tool for clinicians.

Keywords: epilepsy, antiepileptic drugs, pathogenesis, epileptogenesis, levetiracetam, pharmacokinetics, treatment of epilepsy, pro-inflammatory cytokins, inflammation