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Levetiracetam as a treatment option in non-convulsive status epilepticus
- Source :
- Epilepsy Research. 73:238-244
- Publication Year :
- 2007
- Publisher :
- Elsevier BV, 2007.
-
Abstract
- Non-convulsive status epilepticus (NCSE) is characterized by continuous or recurrent, generalized or focal epileptiform activity on the electroencephalogram and diverse clinical symptoms with alterations of mental state and vigilance. NCSE is not rare but certainly under diagnosed. There is some debate about how aggressive NCSE should be treated, as high dose anticonvulsants maybe partially responsible for the morbidity and mortality of patients with NCSE. We hypothesized that levetiracetam (LEV) as a well tolerated, highly effective new anticonvulsant, may be a safe treatment option. We retrospectively analyzed all (8) patients with NCSE who received levetiracetam from our database, compared with 11 patients with NCSE treated with conventional intravenous status medication as controls. These eight patients showed a marked clinical improvement with final cessation of ictal EEG-activity and clinical symptoms of NCSE after initiation of LEV within 3 days (mean 1.5 days). The response to conventional treatment was similarly effective but there were severe side effects whereas no relevant side effects in the LEV-treated group were noticed. A long-term follow up (6-36 months from discharge) revealed six patients with a persisting reduction in seizure frequency on medication with LEV. One patient changed the anticonvulsive medication because of inefficacy and one died from other causes than epilepsy 2 months after discharge from hospital. We found no significant differences in hospitalisation time, time in intensive care unit and outcome between the LEV group and the control group. This retrospectively acquired data suggests that LEV may be a well tolerated, effective treatment option in NCSE. This highlights the need for a prospective controlled study to further elucidate the utility of LEV in the treatment of NCSE, particularly as an intravenous formulation is now available.
- Subjects :
- Levetiracetam
media_common.quotation_subject
medicine.medical_treatment
Status epilepticus
law.invention
Central nervous system disease
Epilepsy
Status Epilepticus
law
medicine
Humans
Ictal
Aged
Retrospective Studies
media_common
Aged, 80 and over
business.industry
Electroencephalography
Middle Aged
medicine.disease
Piracetam
Intensive care unit
Anticonvulsant
Neurology
Anesthesia
Anticonvulsants
Female
Epilepsies, Partial
Neurology (clinical)
medicine.symptom
business
Follow-Up Studies
medicine.drug
Vigilance (psychology)
Subjects
Details
- ISSN :
- 09201211
- Volume :
- 73
- Database :
- OpenAIRE
- Journal :
- Epilepsy Research
- Accession number :
- edsair.doi.dedup.....06afd990f2b2915df033aeea54f31057