Abstracts

Rationale: In May 2006 levitiracetam was approved as the first of the newer anticonvulsive drugs as intravenous formulation (ivLEV) for patients with epileptic seizures who are unable to take oral medication. So far, there are few reports on the oral use of LEV in refractory, non-convulsive SE and a single case report about the administration of ivLEV in one patient with non-convulsive SE (5,6): We report our experience with the use of ivLEV in 16 patients with convulsive and non-convulsive status epilepticus. Methods: Patients with SE who were treated with ivLEV in our department from 05/2006 – 03/2007 were identified retrospectively and were analyzed regarding epilepsy syndrome, etiology, treatment success and side effects.Results: 17 patients with 19 episodes of SE were treated with ivLEV from 05/2006 – 03/2007. All patients were diagnosed with focal SE, either from complex partial SE with motor symptoms (12 episodes), without motor symptoms (“non-convulsive”) (2 episodes) or from secondary generalized SE (4 episodes9. SE was controlled by the applied combination of medication in all patients. One patient needed intubation and sedation (patient 1). Seven patients had already been diagnosed with epilepsy previously, three of them were treated with oral LEV prior to admission. All patients received at least a benzodiazepine (lorazepam in 95%) before ivLEV was given. The mean loading dose was 950 mg (+/- 400 mg) ivLEV, the mean maintenance dose over 24h was 2250 mg (+/- 1250 mg). No severe adverse events occurred. Conclusions: IvLEV appeared to be effective and was well tolerated. Status epilepticus ceased after the applied combination of anticonvulsive drugs in all patients. 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, randomized, controlled study is warranted to investigate the efficacy and safety of ivLEV for the treatment of SE.