Journal of Neurology

, Volume 256, Issue 10, pp 1634–1642

Intravenous levetiracetam as treatment for status epilepticus

  • Sascha Berning
  • Frank Boesebeck
  • Andreas van Baalen
  • Christoph Kellinghaus
Original Communication

Abstract

There are established drugs for the treatment of status epilepticus (SE) but their potentially hazardous side-effects are well known. Levetiracetam (LEV) is a novel anticonvulsant available for intravenous (i.v.) application. It could be an alternative when standard drugs fail or should be avoided. We retrospectively identified patients from two German teaching hospitals who were treated with LEV i.v. for SE. Their charts were reviewed regarding sociodemographic data, type, etiology, onset and duration of SE, dose of LEV, concurrent antiepileptic drugs (AED) treatment, tolerability, and outcome. Thirty-two patients (15 female) were found who were treated with i.v. LEV for SE (median age 71 years). Two patients were exclusively treated with LEV. Eight received a low and further 20 patients a high dose of benzodiazepines before LEV. Two patients were treated with LEV to enable discontinuation of narcosis. SE was generalized convulsive in five, nonconvulsive in 20, and simple focal in seven patients. Etiology was acute 13 times and remote symptomatic 16 times; three SE were of unknown etiology. Therapy was initiated within a median time of 3 h and LEV i.v. was applied within a median time of 6 h. Median LEV bolus was 2,000 mg; median total dose on day 1 was 3,500 mg. Benzodiazepines plus i.v. LEV terminated SE in 23 patients without application of additional anticonvulsants, 10 within 30 min. LEV could not terminate SE in seven patients. We documented nausea and emesis in one and elevation of liver enzymes in another patient that were likely to be attributed to LEV. LEV i.v. seems to be safe with relevant efficiency for the treatment of SE in elderly and multimorbid patients when comorbidity and respiratory insufficiency precludes high doses of benzodiazepines or phenytoin.

Keywords

Status epilepticus Treatment Intravenous levetiracetam 

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Sascha Berning
    • 1
  • Frank Boesebeck
    • 2
  • Andreas van Baalen
    • 3
  • Christoph Kellinghaus
    • 1
  1. 1.Department of NeurologyKlinikum OsnabrückOsnabrückGermany
  2. 2.Department of NeurologyDiakoniekrankenhaus Rotenburg/WümmeRotenburg (Wümme)Germany
  3. 3.Department of NeuropediatricsUniversity Medical Center Schleswig-Hostein, Campus KielKielGermany

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