Despite increasing clinical use of both agents, there is a paucity of head-to-head comparative data on the safety and efficacy of brivaracetam versus levetiracetam as initial monotherapy in children. The present study was therefore designed to compare the safety and efficacy of oral brivaracetam and levetiracetam as monotherapy in children aged one month to 14 years with newly diagnosed epilepsy.

Most existing studies have focused on adjunctive use or refractory epilepsy, while evidence in treatment-naïve pediatric populations remains sparse. Addressing this gap is critical, as early and effective seizure control can substantially influence long-term neurodevelopmental outcomes. By evaluating seizure outcomes, tolerability, and adverse effect profiles, this study aims to provide evidence to guide clinicians in selecting the most appropriate first-line anti-seizure medication (ASM) for pediatric patients.

Inclusion Criteria:

• Children of either gender
• Aged 1 month to 14 years
• With a clinical diagnosis of newly diagnosed epilepsy

Exclusion Criteria:

• History of prior use of long-term antiseizure medications
• Evidence of progressive neurological disease
• Metabolic abnormalities
• Structural brain malformations
• Incompatible with monotherapy
• Severe systemic comorbidities

Data can be shared on a reasonable request.