Intravenous Levetiracetam as first-line treatment of status epilepticus in the elderly

Acta Neurol Scand. 2010 Jun;121(6):418-21. doi: 10.1111/j.1600-0404.2010.01351.x.

Abstract

Background: Status epilepticus is a condition of prolonged/repetitive seizures that often occurs in the elderly. Treatment in the elderly can be complicated by serious side effects associated with traditional drugs.

Objective: The aim of this pilot study was to evaluate the short-term efficacy/safety of intravenously administered LEV (IVLEV) as the treatment of choice for SE in the elderly.

Methods: We enrolled nine elderly patients (five female/four male; median age 78 years) with SE. Two patients had a previous diagnosis of epilepsy; in the remaining seven, SE was symptomatic. SE was convulsive in five and non-convulsive in four. All the patients presented concomitant medical conditions (arrhythmias/respiratory distress/hepatic diseases). As the traditional therapy for SE was considered unsafe, IVLEV was used as first-line therapy (loading dose of 1500 mg/100 ml/15 min, mean maintenance daily dose of 2500 mg/24 h) administered during video-EEG monitoring.

Results/conclusions: In all the patients but one, IVLEV was effective in the treatment of SE and determined either the disappearance of (7/8), or significant reduction in (1/8), epileptic activity; no patient relapsed in the subsequent 24 h. No adverse events or changes in the ECG/laboratory parameters were observed. These data suggest that IVLEV may be an effective/safe treatment for SE in the elderly.

Publication types

  • Clinical Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anticonvulsants / administration & dosage*
  • Female
  • Geriatrics*
  • Humans
  • Injections, Intravenous / methods
  • Levetiracetam
  • Male
  • Pilot Projects
  • Piracetam / administration & dosage
  • Piracetam / analogs & derivatives*
  • Status Epilepticus / drug therapy*
  • Treatment Outcome

Substances

  • Anticonvulsants
  • Levetiracetam
  • Piracetam