TITLE

Experience with Intravenous Levetiracetam in Status Epilepticus A Retrospective Case Series

AUTHOR(S)
Gámez-Leyva, Gonzalo; Aristín, José Luis; Fernández, Emilio; Pascual, Julio
PUB. DATE
November 2009
SOURCE
CNS Drugs;2009, Vol. 23 Issue 11, p983
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Status epilepticus is a medical emergency associated with significant morbidity and mortality. Objective: To report our experience with the use of intravenous (IV) levetiracetam in patients with status epilepticus who had not responded to IV benzodiazepines. Methods: A retrospective review of the clinical charts of patients with status epilepticus who were treated with IV levetiracetam from July 2007 to July 2008 in our department was performed. Data on demographics, epileptic syndrome, aetiology, treatment dosage and adverse effects were analysed. IV levetiracetam was administered over a period of 15-30 minutes; each 500 mg of levetiracetam was diluted in 100 mL of normal saline. Results: Thirty-four patients (19 men and 15 women, 11-90 years old) with status epilepticus were treated with IV levetiracetam. Six patients (18%) had primarily generalized status epilepticus and 28 (82%) had focal status epilepticus. The aetiologies were: vascular (47%), cryptogenic (24%), tumours (12%), metabolic (12%) and brain anoxia (6%). The indications for administering IV levetiracetam were: no response to IV phenytoin and/or IV valproic acid (53% of patients) or to avoid adverse effects, contraindications or potential interactions (47% of patients). The median loading dose of IV levetiracetam was 1000 mg and the maintenance dosage ranged from 500 to 1500mg/12 hours (median 1000 mg/12 hours). Status epilepticus stopped in a clear temporal relationship with IV levetiracetam in 71% of patients. IV levetiracetam was especially effective in older patients with vascular status epilepticus, while cryptogenic status epilepticus, primarily generalized status epilepticus, previous therapy with IV phenytoin and/or valproic acid and status epilepticus due to brain anoxia were associated with a poor response. There were no serious adverse events documented in the patients' charts. Conclusions: While waiting for large, controlled studies, our data suggest that IV levetiracetam might be an alternative for the treatment of status epilepticus, especially in elderly patients with vascular status epilepticus and concomitant medical conditions.
ACCESSION #
47249842

 

Related Articles

  • Phenytoin hypersensitivity syndrome. Güngör, E.; Alli, N.; Çomoğlu, S.; Çömcüoğlu, C. // Neurological Sciences;Jun2001, Vol. 22 Issue 3, p261 

    Phenytoin hypersensitivity syndrome (PHS) is a rare, and important entity characterized by rash, fever, lymphadenopathy, leukocytosis with atypical lymphocytes, eosinophilia and associated hepatitis. In this article, we present the clinical, laboratory and histopathologic results of 5 cases of...

  • Epilepsy experts seek non-drug therapies that spare skin, hair. Pfeiffer, Naomi // Dermatology Times;Jul2002, Vol. 23 Issue 7, p24 

    Examines the efficacy of the anti-epileptic drugs Valproate and Phenytoin in treating patients with hirsutism. Side effects of the drugs; Reduction of the fragility of the hair; Availability of the drugs.

  • Valproic acid.  // Reactions Weekly;5/21/2011, Issue 1352, p37 

    The article describes the case of a 36-year-old man who developed hyperammonaemic encephalopathy while taking phenytoin, levetiracetam and valproic acid.

  • Phenytoin/valproic acid withdrawal.  // Reactions Weekly;4/14/2012, Issue 1397, p25 

    The article describes the case of a male neonate who developed episodic hypoglycaemia and jitteriness secondary to valproic acid and phenytoin withdrawal after in utero exposure.

  • Phenytoin-valproate interaction: importance of saliva monitoring in epilepsy. Knott, Christine; Hamshaw-Thomas, Anne; Reynolds, Felicity // British Medical Journal (Clinical Research Edition);1/2/1982, Vol. 284 Issue 6308, p13 

    Discusses the interaction of phenytoin and sodium valproate. Importance of saliva monitoring in epilepsy; Degree of phenytoin binding; Effects of valproate concentration on phenytoin protein binding.

  • IV Valproic Acid vs Phenytoin: Old Standby or the New Challenger? Kandula, Padmaja // Neurology Alert;Dec2008, Vol. 27 Issue 4, p26 

    HISTORICALLY, THE BENZODIAZEPINES AND PHENYTOIN have been used as first-line therapy in aborting status epilepticus (SE). The rationale for use of these two agents mainly rests on the 1998 results of the Veterans Affairs Cooperative Trial. The greatest response rate was seen in those patients...

  • Persistent cerebellar ataxia with cerebellar cognitive affective syndrome due to acute phenytoin intoxication: A case report. Gupta, Meena; Patidar, Yogesh; Khwaja, Geeta A.; Chowdhury, Debashish; Batra, Amit; Dasgupta, Abhijit // Neurology Asia;Mar2013, Vol. 18 Issue 1, p107 

    Phenytoin is one of the commonly used antiepileptic drugs. The common dose dependent and reversible neurological side effects of phenytoin are nystagmus, diplopia, dysarthria, ataxia, incoordination, chorioathetosis, orofacial dyskinesias and drowsiness. Persistent cerebellar dysfunction with...

  • Poststroke Epilepsy. Ferro, José M.; Pinto, Francisco // Drugs & Aging;2004, Vol. 21 Issue 10, p639 

    Seizures and status epilepticus can be a presenting feature of acute stroke. They may occur in its early (<7 days) clinical course or be a remote (>7 days) complication. Most seizures are single, either partial or generalised. Early and remote seizures seem to have different predictors and...

  • Influence of Enzyme-Inducing Antiepileptic Drugs on Trough Level of Imatinib in Glioblastoma Patients. Pursche, Stefan; Schleyer, Eberhard; von Bonin, Malte; Ehninger, Gerhard; Said, Samir Mustafa; Prondzinsky, Roland; Illmer, Thomas; Yanfeng Wang; Hosius, Christian; Nikolova, Zariana; Bornhäuser, Martin; Dresemann, Gregor // Current Clinical Pharmacology;Sep2008, Vol. 3 Issue 3, p198 

    Background: Imatinib mesylate is used in combination with hydroxyurea (HU) in ongoing clinical phase II studies in recurrent glioblastoma multiforme (GBM). CYP3A4 enzyme-inducing antiepileptic drugs (EIAEDs) like carbamazepine, phenytoin, and oxcarbazepine -- as well as non-EIAEDs like valproic...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics