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Abstract

Background: Epilepsy is among the most common chronic neurological disorders in children, with considerable impact on cognitive and psychosocial development. Sodium valproate is a traditional broad-spectrum antiepileptic drug, while levetiracetam, a newer agent, offers a distinct mechanism of action and promising clinical outcomes. Limited head-to-head data exist comparing these two treatments in early childhood epilepsy.
Objective: To compare the clinical efficacy of levetiracetam and sodium valproate monotherapy in the management of early childhood epilepsy.
Methods: A randomized controlled trial was conducted at the Department of Pediatrics, Northwest General Hospital, Peshawar, over six months. A total of 116 children aged 1–8 years diagnosed with epilepsy were equally randomized into two treatment groups: Group A received sodium valproate and Group B received levetiracetam. Baseline and post-treatment seizure frequencies were recorded, and efficacy was defined as >50% reduction in seizure frequency after 4 weeks. Data were analyzed using SPSS v25 with p ≤ 0.05 considered statistically significant.
Results: Out of 116 patients, 34 (58.6%) in the valproate group and 52 (89.7%) in the levetiracetam group met the efficacy criteria. Mean post-treatment seizure frequency significantly declined in both groups, with a greater reduction observed in the levetiracetam group (1.02 ± 0.71) compared to the valproate group (2.95 ± 1.21). The difference in efficacy was statistically significant (p < 0.05).
Conclusion: Levetiracetam showed significantly higher efficacy than sodium valproate in achieving seizure control in children with early-onset epilepsy, suggesting its potential as a first-line treatment in pediatric epilepsy management.