ABSTRACT
Background: Migraine and other recurrent headaches are considered a major public health concern. Levetiracetam, a broad spectrum anti-epileptic have been used in migraine prophylaxis
Objectives: Assessment the efficacy of levetiracetam on migraine in comparison to sodium valproate
Materials and Methods: This randomized double blind clinical trial was performed on patients with migraine headache, diagnosed based on ICDH-version B criteria. One group received levetiracetam and the other group received valproate sodium. The number of migraine attacks per month, the mean duration of attacks and the intensity of pain [VAS] and disability due to headache [MIDAS] were assessed at first and after four weeks of treatment. Data were analyzed in SPSS 20 by Mann-Whitney-U and Chi-square tests. The significance level was set<0.05
Results: Thirty patients [28 women and 2 men, mean age of 35.14 +/- 7.3 years] remained in the valproate group and 33 patients [31women and 2 men, mean age of 36.33 +/- 6.7 years] in the levetiracetam group. The patients in both groups showed a statistically significant reduction in the frequency of headache [p=0.0001]; intensity of headache [p=0.004]; mean duration of attacks [p=0.0001] and MIDAS score of disability [p=0.004] compared to baseline. There was also a statistically significant difference between the two groups in terms of frequency of attacks [p=0.0001], intensity of pain [p=0.0001]; and MIDAS score [p=0.0001], by the end of the treatment with superiority of levetiracetam
Conclusion: Levetiracetam, compared to valproate, yielded better results in prophylaxis of migraine headache
ABSTRACT
Background: Epilepsy is the second common neurologic disorder. Althoug many antiepileptic drugs have been formulated to control the seizures, but not all seizures have been controlled by them. Uncontrolled epilepsy can actually reduce the patients' quality of life
Objectives: Identifying the proportion of adult intractable epilepsy among epileptic patients in an area in the North East of Iran
Materials and Methods: All epileptic patients who admitted to neurology clinic of a teaching hospital associated with Islamic Azad University of Mashhad in 2014 that were eligible for inclusion criteria enrolled this cross-sectional study. After fulfilling the informed consent, interview, examination and EEG were done
The data was expressed and analyzed by using Mean+/-Standard deviation and the Likelihood Ratio Chi-Square test in SPS! software version 22. Significance level was considered as less than 0.05%. Results: From 171 patients, 59 patients with epilepsy [34.5%] met the criteria for intractable epilepsy [37.5% male, 31.3% female] with mean age of 28.2+/-8.5 years. The mean duration of disease was 14.5+/-8.4 and 11+/-8.8 years in patients with refractory epilepsy and controlled epilepsy respectively [t-test=2.5 and p=0.013]
The seizure frequency was significantly higher in pharmacoresistant patients than pharmacoresponsive ones [7.15+/-8.4 vs. 0.29+/-7 per month p=0.0001]
Also taking Carbamazepin and Clobazam and Primidone were associated with intractable epilepsy [p<0.05]
Conclusions: Our results accounted that about one-third of patients with epilepsy are categorized in refractory epilepsy with higher duration of disease