Levetiracetam for pediatric migraine prophylaxis: A narrative review.

Background: Migraine, a common primary headache disorder, affects children and adolescents under 18, often bilateral and lasting 2-72  hours, affecting 7.7% of them.

Objective: Recent studies on migraine prevention and treatment in children and adolescents have explored the potential benefits of levetiracetam, considering its side effects and potential effects on migraines. Hence, we aimed to review the studies that have examined the possible mechanism and beneficial effects of levetiracetam in children's and adolescents' migraine.

Methods: A comprehensive search of English and non-English trials evaluating levetiracetam's effectiveness in pediatric migraine treatment using relevant keywords was conducted in scientific databases including PubMed, Web of Science, and the Cochrane Controlled Trials Register in Feb 2024. The studies included non-randomized controlled trials, uncontrolled trials, and retrospectively reviewed medical charts plus randomized controlled trials.

Results: Seven studies were included in this review. They revealed that levetiracetam can promisingly complete the resolution of migraines, and decrease the duration, severity, number of migraine episodes, and frequency of migraine in children. In addition, levetiracetam diminished the Pediatric Migraine Disability Assessment Scale score in them.

Conclusion: Seven studies suggest levetiracetam, at doses ranging from 20 to 60 mg/kg/day (250-3000 mg/day), can significantly reduce migraine frequency and duration, but larger controlled trials are needed.