Brivaracetam (BRV) is a novel third-generation antiseizure medication characterized by its high-affinity selective binding to synaptic vesicle protein 2A (SV2A). Its pharmacokinetic profile is marked by linear and dose-proportional metabolism, low protein binding, and a low risk of drug-drug interactions, eliminating the need for dosage adjustment in cases of renal impairment. Clinical studies have confirmed its efficacy and acceptable tolerability as an adjunctive therapy for children with epilepsy. Although existing data support BRV as a valuable therapeutic option, its optimal dosing strategies and specific indications in the pediatric population warrant further investigation. This review provides a comprehensive evaluation of BRV to guide evidence-based management of pediatric epilepsy.
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