Intravenous levetiracetam in the treatment of benzodiazepine refractory status epilepticus

J Neurol Neurosurg Psychiatry. 2008 May;79(5):588-9. doi: 10.1136/jnnp.2007.130260. Epub 2007 Sep 26.

Abstract

In 2006, levetiracetam was approved as the first of the newer anticonvulsive drugs as an intravenous formulation (ivLEV) for patients with epileptic seizures who are unable to take oral medication. We report our experience with the use of ivLEV for the treatment of 18 episodes of benzodiazepine refractory focal status epilepticus (SE) in 16 patients, including four patients with secondary generalised SE. SE was controlled in all patients by the given combination of drugs; application of further antiepileptic medications after ivLEV was necessary in two episodes. No severe side effects occurred. Our data suggest that ivLEV may be an alternative for the treatment of SE in the future, even in patients that did not respond to benzodiazepines. A large prospective, randomised, controlled study is warranted to investigate the efficacy and safety of ivLEV for the treatment of SE.

MeSH terms

  • Administration, Oral
  • Adult
  • Aged
  • Aged, 80 and over
  • Anticonvulsants / adverse effects
  • Anticonvulsants / therapeutic use*
  • Benzodiazepines / adverse effects
  • Benzodiazepines / therapeutic use
  • Dose-Response Relationship, Drug
  • Drug Resistance
  • Drug Therapy, Combination
  • Electroencephalography / drug effects
  • Epilepsy, Complex Partial / diagnosis
  • Epilepsy, Complex Partial / drug therapy*
  • Female
  • Humans
  • Infusions, Intravenous
  • Levetiracetam
  • Male
  • Middle Aged
  • Piracetam / adverse effects
  • Piracetam / analogs & derivatives*
  • Piracetam / therapeutic use
  • Retrospective Studies
  • Status Epilepticus / diagnosis
  • Status Epilepticus / drug therapy*

Substances

  • Anticonvulsants
  • Benzodiazepines
  • Levetiracetam
  • Piracetam