• Acta neurochirurgica · Feb 2012

    Clinical Trial

    Intravenous and oral levetiracetam in patients with a suspected primary brain tumor and symptomatic seizures undergoing neurosurgery: the HELLO trial.

    • Oliver Bähr, Mirjam Hermisson, Sabine Rona, Johannes Rieger, Susanne Nussbaum, Peter Körtvelyessy, Kea Franz, Marcos Tatagiba, Volker Seifert, Michael Weller, and Joachim P Steinbach.
    • Dr. Senckenberg Institute of Neurooncology, Johann Wolfgang Goethe University Frankfurt, Schleusenweg 2-16, 60528 Frankfurt, Germany. oliver.baehr@med.uni-frankfurt.de
    • Acta Neurochir (Wien). 2012 Feb 1;154(2):229-35; discussion 235.

    BackgroundLevetiracetam (LEV) is a newer anticonvulsant with a favorable safety profile. There seem to be no relevant drug interactions, and an intravenous formulation is available. Therefore, LEV might be a suitable drug for the perioperative anticonvulsive therapy of patients with suspected brain tumors undergoing neurosurgery.MethodsIn this prospective study (NCT00571155) patients with suspected primary brain tumors and tumor-related seizures were perioperatively treated with oral and intravenous LEV up to 4 weeks before and until 4 weeks after a planned neurosurgical procedure.FindingsThirty patients with brain tumor-related seizures and intended neurosurgery were included. Three patients did not undergo the scheduled surgery after enrollment, and two patients were lost to follow-up. Therefore, 25 patients were fully evaluable. After initiation of therapy with LEV, 100% of the patients were seizure-free in the pre-surgery phase (3 days up to 4 weeks before surgery), 88% in the 48 h post-surgery phase and 84% in the early follow-up phase (48 h to 4 weeks post surgery). Treatment failure even after dose escalation to 3,000 mg/day occurred in three patients. No serious adverse events related to the treatment with LEV occurred.ConclusionOur data show the feasibility and safety of oral and intravenous LEV in the perioperative treatment of tumor-related seizures. Although this was a single arm study, the efficacy of LEV appears promising. Considering the side effects and interactions of other anticonvulsants, LEV seems to be a favorable option in the perioperative treatment of brain tumor-related seizures.

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