INTRODUCTION Strokes are the leading cause of epileptic seizures in adults and account for 50% of seizures in those over the age of 65. These patients present certain specific characteristics with respect to the remaining population, which makes it necessary to look for medication that are suited to their particular case.

AIM To describe the effectiveness and safety of levetiracetam (LEV) in monotherapy in elderly patients with post-stroke epileptic seizures.

PATIENTS AND METHODS A prospective evaluation was conducted of a series of cases consisting of patients over the age of 60 years who had suffered a stroke and had had at least one epileptic seizure in the late post-stroke phase (more than two weeks). Demographic data and the characteristics of the epilepsy and the stroke were collected. Patients began treatment with LEV in monotherapy, underwent check-ups at one and six months of treatment, and the effectiveness and safety of the drug were evaluated.

RESULTS The sample consisted of 25 patients with a mean age of 75.2 ± 7.6 years. They presented an average of 3.2 ± 5.6 post-stroke seizures and the time elapsed since the stroke was 38.3 ± 81.8 months. After six months’ follow-up, 76% of the patients were still receiving treatment with LEV. Of the patients under treatment, 89.5% were free from seizures. Side effects that could be attributed to LEV were noted by 28% of patients, but did not compel them to stop treatment.

CONCLUSIONS LEV in monotherapy can be a safe, effective therapeutic option for elderly patients who have presented epilepsy following a stroke.

Introducción Los ictus son la primera causa de crisis epilépticas en adultos y los responsables del 50% de crisis en mayores de 65 años. Estos pacientes presentan unas características propias respecto al resto de la población, por lo que se hace necesario buscar fármacos que resulten apropiados.

Objetivo Describir la eficacia y tolerabilidad del levetiracetam (LEV) en monoterapia en pacientes ancianos con crisis epilépticas postictus.

Pacientes y métodos Se evaluó prospectivamente una serie de casos formada por pacientes mayores de 60 años que hubieran sufrido un ictus y presentaran, al menos, una crisis epiléptica en la fase tardía (más de dos semanas) postictus. Se recabaron datos demográficos, características de la epilepsia y del ictus. Los pacientes iniciaron tratamiento con LEV en monoterapia, fueron controlados al mes y a los seis meses de tratamiento, y se evaluó la eficacia y tolerabilidad del fármaco.

Resultados Se incluyeron 25 pacientes con edad media de 75,2 ± 7,6 años. Presentaron una media de 3,2 ± 5,6 crisis postictus y un tiempo trascurrido desde el ictus de 38,3 ± 81,8 meses. Tras seis meses de seguimiento, el 76% de los enfermos continuaba tratamiento con LEV. De los pacientes con el tratamiento, el 89,5% se mantenía libre de crisis. El 28% había presentado algún efecto secundario atribuible al LEV que no obligó a la suspensión del tratamiento.

Conclusión El LEV en monoterapia puede ser una opción terapéutica eficaz y segura para aquellos pacientes ancianos que hubieran presentado epilepsia tras sufrir un ictus.