<b>Efficacy and Safety of Levetiracetam for Epilepsy in Children: A Systematic Review and Meta-Analysis</b>

<b>Objective</b>To investigate and validate the clinical efficacy and safety of levetiracetam intervention drug administered as a monotherapy or adjunctive therapy in treating children below 18 years of age diagnosed with epilepsy.<br><b>Methods</b>Online databases (PubMed (Medline), Web of Science, Cochrane Library, and EMBASE) were electronically searched with Keywords and MeSH terms including pediatric, child, neonate, seizure, epilepsy, anticonvulsive, levetiracetam, and Keppra from inception to September 2022 to establish high-quality studies for inclusion in this study. The data were extracted, and outcomes were measured on seizure-free rates, a seizure-frequency reduction from baseline (≥50% reduction rates), and the adverse effects. The meta-analysis was performed using the RevMan version 5.4 software.<br><b>Results</b>After being ascertained based on the predetermined eligibility criteria, a total of 14 articles were finally included in this meta-analysis. Based on the pooled meta-analysis results of different outcomes, the study suggested a superior efficacy and safety profile of levetiracetam over placebo or other AEDs. Some forms of minor adverse events were also associated with AED drug administration. Compared with others, such as PHB and COX, the incidences of adverse events were substantially lower in levetiracetam, making it safe for children.<br><b>Conclusion</b>The meta-analysis concluded that levetiracetam was clinically effective and safe in treating epilepsy in children.

<b>研究目的</b>本研究旨在探究并验证左乙拉西坦（levetiracetam）作为单一疗法或辅助疗法，用于治疗确诊癫痫的18岁以下儿童的临床疗效与安全性。<br><b>研究方法</b>本研究通过电子检索自建库至2022年9月的在线数据库，包括PubMed（Medline）、Web of Science、Cochrane图书馆及EMBASE，检索词涵盖儿科、儿童、新生儿、痫性发作、癫痫、抗惊厥药、左乙拉西坦（levetiracetam，商品名开浦兰（Keppra）），以筛选符合要求的高质量研究纳入本研究。随后提取相关研究数据，以无痫性发作率、较基线痫性发作频率降低≥50%的比例及不良反应作为主要结局指标进行评估。本研究采用RevMan 5.4版本软件开展荟萃分析。<br><b>研究结果</b>经预先设定的纳入排除标准筛选确认后，最终共有14篇文献纳入本次荟萃分析。基于不同结局指标的合并荟萃分析结果，本研究显示左乙拉西坦的疗效与安全性均优于安慰剂及其他抗癫痫药物（AEDs）。部分轻度不良反应与抗癫痫药物治疗相关。与PHB、COX等其他抗癫痫药物相比，左乙拉西坦的不良反应发生率显著更低，因此用于儿童患者具有良好的安全性。<br><b>研究结论</b>本次荟萃分析得出结论：左乙拉西坦用于治疗儿童癫痫具有确切的临床疗效与良好的安全性。