Journal of Advanced Clinical Neurology Research

Abstract

Background and Objectives: Epilepsy is one of the most common chronic neurological disorders in childhood

and is associated with behavioral comorbidities such as attention deficit hyperactivity disorder (ADHD) and

oppositional defiant disorder (ODD). Levetiracetam (LEV), a broad-spectrum antiepileptic drug, has gained

popularity for pediatric use due to its favorable pharmacokinetic profile. However, its behavioral side effects

remain a concern, with inconsistent findings across studies. This study aimed to determine the incidence and

pattern of behavioral and mood disorders following LEV administration in children with epilepsy.

Materials and Methods: In this longitudinal study, 77 children aged over three years with epilepsy who referred

to Mofid Children’s Hospital, Tehran, from March 2024 to March 2025 were evaluated. Behavioral symptoms,

including Hyperactivity, ODD, and sleep disturbances, were assessed according to the DSM-5 criteria before

and six months after starting LEV therapy. Data were analyzed using SPSS version 24, employing chi-square

and t-tests for comparison.

Results: The mean age of participants was 7.16 ± 3.24 years. After six months of LEV therapy, DSM-5 behav

ioral scores significantly increased (p < 0.001). Following six months of treatment, the proportion of children

exhibiting irritability, impulsivity, and restlessness nearly tripled, increasing from 10.4%, 6.5%, and 5.2% to

27.3%, 16.9%, and 16.9%, respectively. Sleep disturbances also slightly increased.

Conclusion: Levetiracetam usage was significantly associated with increased behavioral symptoms, particu

larly Hyperactivity- and ODD-related features. Careful behavioral monitoring is recommended during LEV

therapy to ensure early detection and individualized management.