Systematic review of levetiracetam in treatment of febrile convulsions in children

Zhou Ling-han; Chen Rong-fei

doi:10.3969/j.issn.1672-8157.2025.01.041

Abstract：Objective To systematically evaluate the current application status of levetiracetam in treatment of febrile convul-sions in children.Methods A systematic search was conducted for randomized controlled trials of levetiracetam in the treatment of febrile convulsions in children in CNKI,PubMed,Embase,CBM,VIP and Wanfang databases from January 2014 to June 2024.The literature was screened and included and the data were extracted to perfom the systematic review.Results The study included 10 documents of 1 in English and the rest in Chinese.In the control group,423 children received conventional antipyretics,diaze-pam,sodium valproate,etc.In the experimental group,466 children received levetiracetam alone or combined with levetiracetam on the basis of the control group.The course of treatment within 1 to 2 weeks,6 documents reported clinical effectiveness,exper-imental group reported a higher clinical efficacy rate compared to control group(95.35%vs 79.30%,χ2=29.972,P<0.05).Eight documents reported convulsion recurrence rate,the recurrence rate of convulsions in the experimental group was lower than that in the control group(7.71%vs 25.83%,χ2=42.636,P<0.05).Four documents reported progressive epilepsy rate,the total progressive epilepsy rate of the experimental group was lower than that of the control group(0.18%vs 11.59%,χ2=12.677,P<0.05).Seven doc-uments reported adverse reaction rates,the adverse reaction rate of the experimental group was lower than that of the control group,showing no significant difference(8.10%vs 12.23%,χ2=2.820,P>0.05).Meanwhile,no serious adverse reactions were observed.Conclusion Levetiracetam is more effective in treating febrile convulsions in children.Currently,evidence shows that it has the advantages of preventing disease recurrence and progression,preventing neurological damage,and is safe and has good therapeutic effects on complications related to febrile convulsions.The development prospects are objective,but the current study lacks long-term follow-up data and long-term treatment effects.Moreover,the impact on the cognitive function of the children has not been clar-ified.The impact on the long-term prognosis of febrile convulsions and the dosing regimens for special populations such as liver and renal insufficiency and infants need further study.