Summary

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• This summary is based on the review of 40 systematic review(s)/meta-analysis(es). ^[1-40]
• In children with epilepsy, there was no significant difference in seizure-free rate (RR (relative risk) = 1.010, 95% CI (confidence interval) [0.822, 1.242], P > 0.05) or reduction in seizure frequency (≥50%) (RR = 0.938, 95% CI [0.676, 1.301], P > 0.05) between Levetiracetam (LEV) and Oxcarbazepine (OXC).
• Among adults and children with focal and generalized seizures, Lamotrigine showed lower treatment failure rates for focal seizures than most other AEDs (antiepileptic drugs), with no significant difference in treatment failure rates between Lamotrigine and Levetiracetam; for generalized seizures, Valproate, Lamotrigine, and Levetiracetam showed no significant differences.
• For idiopathic generalized epilepsies, Valproate and Ethosuximide were more effective than Lamotrigine in achieving seizure freedom, while Topiramate was the most effective adjunctive treatment for generalized tonic-clonic seizures alone (GTCA), and Levetiracetam was most effective for myoclonic seizures.
• In drug-resistant focal epilepsy, Levetiracetam as an add-on therapy led to a significant reduction in seizures compared to placebo (RR 2.37, 95% CI [2.02, 2.78]).
• Levetiracetam vs. Oxcarbazepine in Children: No significant differences in total adverse reaction rate (RR = 1.113, 95% CI [0.710, 1.744], P > 0.05) or failure rate due to serious adverse reactions (RR = 1.001, 95% CI [0.349, 2.871], P > 0.05).
• Behavioral and Respiratory Adverse Events: Levetiracetam is associated with behavioral changes in children, affecting 23% (RR 1.90, 99% CI 1.16 to 3.11). Incidents of respiratory depression are lower with Levetiracetam compared to Phenytoin in pediatric status epilepticus.
• Levetiracetam vs. Phenobarbital for Status Epilepticus: Phenobarbital achieves higher seizure control but has increased adverse events, including respiratory depression and cardiovascular instability.
• Levetiracetam demonstrates efficacy and a favorable safety profile in diverse populations, showing no significant differences in seizure control or adverse reaction rates compared to Oxcarbazepine in children, higher seizure freedom rates in elderly patients with better tolerability than Carbamazepine, and safer profiles for thyroid-sensitive children and pregnant women due to fewer impacts on thyroid function and lower risks of congenital malformations than Valproate, Phenytoin, and Phenobarbital.