To compare the safety and efficacy of Lrvetiracetam (LEV) versus Topiramate (TPM) as monotherapy for generalized Tonic-Clonic seizure (GTCS) alone in adults with idiopathic Generalized Epilepsy(IGE).

Out of 60 IGE patients with GTCS alone, 30 cases on oral topiramate (50 mg/day) were recruited in TPM group, and 30 cases taking oral levetiracetam (500 mg twice a day) in LEV group. Follow-up assessments, conducted for three months, aimed to evaluate reductions in seizure frequency and adverse events. Total 51 patients (25 in TPM group and 26 in LEV group) completed the study, and data subjected to final SPSS analysis.

Mean age of 51 patients was 33.0 ± 13.0 years. Women proportion was little higher than men (54.9% vs. 44.1%). Two-third of them had >2 seizures at the time of enrollment. Baseline variables were similar among the two study groups (all p-values >0.05). At a 12-week follow-up visit, overall two-third of the total population became seizure-free. Seizure-free rate in TPM group was considerably greater than the LEV group (p-value 0.088). None of the patients in both groups reported headache, nausea, anxiety and vomiting. Incidence of adverse events in the TPM group was insignificantly higher than the LEV group (all p-values >0.05).

Topiramate was a more efficacious but less tolerated broad-spectrum anti-epileptic drug than levetiracetam for treating GTCS among adults with IGE.