• Epilepsy & behavior : E&B · May 2006

    Multicenter Study

    Determinants of success in the use of oral levetiracetam in status epilepticus.

    • Andrea O Rossetti and Edward B Bromfield.
    • Division of Epilepsy and EEG, Department of Neurology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.
    • Epilepsy Behav. 2006 May 1;8(3):651-4.

    AbstractThe use of new antiepileptic drugs for treatment of status epilepticus (SE) has not been studied systematically, particularly with respect to response predictors, the possibility of a dose-response relationship, and the efficacy of administration through a nasogastric tube. We analyzed 23 patients with SE treated with levetiracetam (LEV). The median daily dose of LEV was 2000 mg (range: 750-9000 mg). Ten patients (43%) responded; all had received LEV within 4 days after the beginning of their SE episode (P=0.019 vs nonresponders), and were administered less than 3000 mg LEV/day (P=0.046). No demographic or etiological variable was predictive. Among 16 patients given LEV through a nasogastric tube, administration was successful in 5; blood levels in 2 nonresponders were within or above the range 5-30 microg/mL. These data suggest that LEV may be a useful alternative in SE if administered early, even in intubated patients, and that escalating the dosage beyond 3000 mg/day will unlikely provide additional benefit.

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