Levetiracetam is a well established second generation antiepileptic drug. It can be used as adjunctive or monotherapy treatment of partial-onset seizures with or without secondary generalisation, or of generalised tonic-clonic seizures.1 The efficacy of Levetiracetam has been demonstrated in numerous randomised controlled explanatory trials in comparison to placebo, but we know little about its effectiveness compared to standard therapy. So far only one randomised controlled head-to-head-trial compared levetiracetam and carbamazepine, and did not find a significant difference regarding seizure freedom rate after 6 months or 1 year.2 The ‘Keppra versus Older Monotherapy in …