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Levetiracetam is a pyrrolidine-based compound effective in the management of partial and tonic-clonic seizures, and it is administered as the S-enantiomer of a stereoisomer pair (Table 16-1).1,2,3, and 4 It is also useful for the treatment of myoclonic seizures in patients with juvenile myoclonic epilepsy. Levetiracetam does not exhibit antiseizure properties in all models used to screen antiepileptic drugs, and its exact mechanism of action is largely unknown. It does bind to a synaptic vesicle protein, SV2A, present in brain tissue, and this action is thought to be important to its therapeutic actions.5,6

TABLE 16-1International Classification of Epileptic Seizures With Recommended Therapies

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