Objective: Rolandic epilepsy (RE) is the most common benign focal epilepsy of childhood. While carbamazepine (CBZ) has been widely used in treatment, levetiracetam (LEV) has become one of the first-line options in recent years due to its efficacy and good tolerability. The aim of this study was to compare CBZ and LEV monotherapies in the treatment of RE.
Material and Methods: Thirty patients with RE (15 treated with CBZ and 15 with LEV) who were followed at Sütçü İmam University during the last three-year period were retrospectively analyzed. Demographic and clinical characteristics, including age, sex, age at seizure onset, seizure type, and seizure frequency, were evaluated.
Changes in seizure frequency after treatment, treatment-related adverse effects, and electroencephalographic (EEG) response were systematically assessed. Results: Of the 30 patients, 20 (66.7%) were male and 10 (33.3%) were female. Twelve patients (80%) in the CBZ group and eight patients (53.3%) in the LEV group were male.
The median age at diagnosis was 8.1 years (6.8-8.9), and the median age at treatment initiation was 8.1 years (7.0-8.8). There were no significant differences between the groups regarding sex distribution, age at diagnosis, or age at treatment initiation. No significant difference was found between the two treatment groups in terms of reduction in seizure frequency after treatment.
EEG normalization during follow-up was observed in 9 patients (31%), with no significant difference between the groups in EEG normalization frequency or time to normalization. Treatment-related adverse effects were observed in 10 patients (33.3%), with no significant difference between the CBZ and LEV groups.
Conclusion: Although no statistically significant differences were found between CBZ and LEV in terms of seizure control, adverse effects, and EEG outcomes, our findings support the use of LEV as an effective monotherapy option in the treatment of childhood RE.