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Fortschr Neurol Psychiatr 2013; 81(1): 21-27
DOI: 10.1055/s-0032-1312951
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Erfahrungen mit Levetiracetam in der Behandlung des Status epilepticus

Experience with Levetiracetam in the Treatment of Status Epilepticus
J. Rösche
,
I. Pohley
,
K. Rantsch
,
U. Walter
,
R. Benecke
Further Information

Publication History

Publication Date:
13 August 2012 (online)

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Zusammenfassung

Für den nonkonvulsiven Status epilepticus (NKSE) und die Epilepsia partialis continua (EPC) sind die therapeutischen Empfehlungen in den meisten Leitlinien nicht so eindeutig wie für den Status generalisierter tonisch-klonischer Anfälle (GTKSE). NKSE und EPC sind aber nicht selten therapierefraktär. Daher kommen hier gelegentlich auch Substanzen zum Einsatz, die über keine Zulassung für die Behandlung eines Status epilepticus (SE) verfügen. Im Rahmen dieser Übersichtsarbeit wurden die bis zum 12.12.2011 in Pub-med gelisteten Fallberichte und Fallserien zur Levetiracetam(LEV)-Anwendung bei unterschiedlichen Formen des SE – ergänzt um durch Literaturverweise gefundene Arbeiten und Abstracts in peer-reviewed-Journals – analysiert. Um den Publikationsbias zu reduzieren, wurden zusätzlich Arbeiten in die Analyse einbezogen, die über Lacosamid(LCM)-Anwendung bei Formen des SE berichten. LEV wurde in Dosen von 500 – 9000 mg eingesetzt. An Nebenwirkungen wurden insbesondere Sedierung und Reizbarkeit berichtet. Mit einer auf Basis der Fallserien geschätzten Gesamterfolgsrate von 53,7 – 58,1 % scheint LEV eine mögliche Behandlungsoption eines SE bei bestehenden Kontraindikationen für etablierte Therapieverfahren oder nach deren erfolglosem Einsatz zu sein.

Abstract

Non-convulsive status epilepticus and epilepsia partialis continua are common epileptic conditions for which straightforward recommendations based on controlled randomised trials for treatment of therapy refractory courses are lacking. Therefore in these conditions sometimes antiepileptic drugs that are not approved by governmental authorities for the treatment of status epilepticus (SE) are used. Here we review all case reports and case series concerning the treatment of SE with levetiracetam (LEV), that had been listed in pub-med up to December 12th 2011. Additionally we analysed abstracts and papers in peer reviewed journals, that were listed in the references of the primarily reviewed papers. Furthermore we looked for LEV treatments in papers on the use of lacosamide (LCM) in SE. LEV was given in dosages ranging from 500 mg to 9000 mg per day. Side effects were especially sedation and irritability. Estimated on the basis of the case series the overall success-rate of LEV in terminating status epilepticus may be set in a range between 53.7 % and 58.1 %. Therefore LEV may be a useful alternative for the treatment of SE when the approved drugs are contraindicated or when these drugs have been taken without success.

Schlüsselwörter

Status epilepticus - Levetiracetam - Erfolgsrate - Alterseinfluss

Key words

status epilepticus - levetiracetam - success rates - influence of age
 

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