Table 1.
Characteristics of the included studies
| Time of outcome assessment | ||||||||
|---|---|---|---|---|---|---|---|---|
| Source | Study design | Study period | Intervention/control | No of pts | Age | <4 weeks | 4w‐12mo | Side effects |
| Bahr et al. 56 | Prospective, open‐label | 4 weeks | LEV po or iv 500 × 2/3d po, then 1000 × 2 | LEV 25 | 23–78 yrs | 6/25 (3/25 48 h postop) | 1/25 paresthesia + visual field deficit | |
| In case of seizures up to 1500 × 2 | ||||||||
| Fuller et al. 26 | Prospective, open‐cohort | 3 mo | LEV vs PHT | LEV 36 | LEV 25–88 yrs | LEV 0/36 | 1/25 paresthesia + nystagmus | |
| LEV 250–1000 × 2 po or iv | PHT 38 | PHT 27–89 yrs | PHT 6/38 (1/38 48 h postop) | |||||
| PHT 300 × 3 or 1gr iv (loading)‐ 300 mg/d po or iv | ||||||||
| Gokhale et al. 58 | Retrospective | 1 week | LEV p.o or i.v. 1000–2000 mg/day | LEV 165 | 18–82 yrs | 12/165 (10 generalized and 2 partial seizures | 7/165 somnolence | |
| Garbossa et al. 59 | Retrospective 2‐centre study | 6 mo | LEV vs control (none) | LEV 43 | LEV 59 | LEV 1/43 | LEV 5/43 (3mo) | LEV 1/43 ataxia |
| LEV 500 × 2/3‐5d preop | Control 48 | 47 (SD 12) | Control 0/48 | Control 3/48 | ||||
| LEV 2/41 (6 mo) | ||||||||
| 500 × 2 for 6 mo postop or 1000 × 2 (in case of seizures) | ||||||||
| Control 63.9 (SD 11.8) | Control 6/45 (6 mo) | |||||||
| Iuchi et al. 25 | randomized, prospective, open‐cohort, study | 7 days | LEV 500 × 2 sup → po | 73 LEV | 1/73 LEV | 3/73 LEV (liver dysfunction | 3/73 LEV liver dysfunction | |
| 11/73 PHT | 8/73 PHT (2 liver dysfunction, 2 hyponatriemia, 2 skin rash, 2 atrial fibrillation) | 2/73 PHT liver dysfunction | ||||||
| 73 PHT | ||||||||
| 2/73 PHT hyponatriemia | ||||||||
| PHT 15–18 mg kg−1 iv → 5–7.5 mg kg−1/day iv, then 250 mg po daily | ||||||||
| 2/73 PHT skin eruption | ||||||||
| 2/73 PHT atrial fibrillation | ||||||||
| Kerkhof et al. 60 | Retrospective | 6 mo | LEV vs VAL | LEV 36 | 24–85 yrs | LEV 8/36 | LEV 1/36 severe fatigue + allergic reaction | |
| LEV p.o or i.v. 1000 mg/day (or 2000 mg/day in case of seizures) | ||||||||
| VA L36 | VAL 11/36 | |||||||
| VAL p.o or i.v. 1000 mg/day (or 2000 mg/day in case of seizures) | ||||||||
| Lee et al. 10 | Retrospective | 4 weeks | LEV vs VAL | LEV 51/282 | LEV 50.6 (SD 16.6) | LEV 4/51 | Total LEV 5/51 | |
| VAL 231/282 | ||||||||
| LEV 500 × 2 iv (preop‐1st postop days) | ||||||||
| VAL 50.9 (SD 17.3) | VAL 15/231 | VAL 62/231 | ||||||
| LEV 500 × 2 1500 × 2 (in case of seizures) | ||||||||
| VAL 600 mg for 12 h preop | ||||||||
| VAL 50 mg for 24 h 1st postop | ||||||||
| VAL 600 mg × 2 titration to serum levels | ||||||||
| Lim et al. 18 | RCT | 6 mo | LEV vs PHT (0 postop) | LEV 15 | LEV 20–56 | LEV 2/15 | LEV 0/15 | |
| LEV 1000 × 2 iv + tapering off PHT up to POD3 | PHT 8 | PHT 32–83 | PHT 2/8 | PHT 3/8 difficulty in coordination | ||||
| PHT 300‐400 mg × 1 according serum levels | ||||||||
| 6 mo evaluation | ||||||||
| Merrell et al. 62 | Retrospective | 4 weeks | LEV vs PHT | LEV 51 | LEV 25–77 | LEV 2/51 | LEV:3/51 | |
| NR | PHT 25 | PHT 32–79 | PHT 5/25 | PHT5/25 | ||||
| Milligan et al. 61 | Retrospective | 12 mo | LEV vs PHT | LEV 105 | Primary brain tumour | LEV 1/43 | LEV 5/11 | |
| LEV 500–3000 mg/d (1000 mg) | ||||||||
| PHT 200–800 mg/d (300 mg) | PHT 210 | LEV 43/105 | PHT 2/56 | PHT 24/44 | ||||
| PHT 56/210 | ||||||||
| Usery et al. 20 | Prospective | 4 weeks | LEV 500 × 2 iv → po | LEV 20 | LEV 27–77 | LEV 1/17 | 3/17 somnolence | |
| Titrated 500 mg per day | 1/17 nausea/vomiting | |||||||
| 1/17 headache | ||||||||
| Up to 3000/d | 1/17 insomnia | |||||||
| Zachenhofer et al. 57 | Retrospective | 12 mo | LEV 500 × 2 iv or 500 × 3 | LEV 78 | LEV 27–89 | LEV 2/78 (7 days) | LEV 7 (whole 180 days) | 3/78 somnolence |
| Titrated up to 3000/d | 5/78 (4 weeks) | 2/78 psychosis | ||||||
LEV, levetiracetam; mo, months; PHT, phenytoin; postop, postoperatively; SD, standard deviation; VAL, valproate; yrs, years