Hospital de Bellvitge, Feixa Llarga s/n, Hospitalet de Llobregat, 08907 Barcelona, Spain.
Seizure. 2011 Jan;20(1):60-4. doi: 10.1016/j.seizure.2010.10.009. Epub 2010 Dec 10.
Treatment of status epilepticus (SE) has not changed in the last few decades, benzodiazepines plus phenytoin being the most common first line treatment. Intravenous levetiracetam (ivLEV) is a new antiepileptic drug with interesting properties for SE.
Efficacy and effectiveness of ivLEV in SE were assessed in an observational, multicentric and retrospective study. Efficacy was defined as cessation of seizures in the 24h subsequent to starting ivLEV, with no need of any further antiepileptic drug. All patients were treated following the standard protocol (benzodiazepines plus phenytoin or valproate). ivLEV was used as add-on therapy, except in those cases with contraindication for the standard protocol, when it was administered earlier.
40 patients were included, 57% men, with a mean age of 63 years. The most common type of SE was partial convulsive (90%). ivLEV was effective in approximately half of the patients (57.5%), in a mean time of 14.4h. ivLEV was used as add-on treatment in 26 patients (after benzodiazepines plus phenytoin, valproate or both) with an efficacy of 46.1%, and as early treatment (pretreatment with benzodiazepines or nothing) in 14 patients with an efficacy of 78.5% (p 0.048). Adverse events were observed in 15% of patients.
ivLEV was an effective antiepileptic drug for SE, but its efficacy depends on the timing of its administration, being more effective when used as early treatment, and less effective as add-on treatment.
在过去几十年中，治疗癫痫持续状态（SE）并没有改变，苯二氮䓬类药物加苯妥英钠仍然是最常见的一线治疗方法。静脉用左乙拉西坦（ivLEV）是一种具有治疗 SE 相关特性的新型抗癫痫药物。
在一项观察性、多中心和回顾性研究中，评估了 ivLEV 在 SE 中的疗效和有效性。疗效定义为在开始使用 ivLEV 后 24 小时内停止发作，无需进一步使用任何抗癫痫药物。所有患者均按照标准方案（苯二氮䓬类药物加苯妥英钠或丙戊酸钠）进行治疗。ivLEV 作为附加治疗，除非在标准方案有禁忌的情况下，才会更早使用。
共纳入 40 例患者，其中 57%为男性，平均年龄为 63 岁。最常见的 SE 类型为部分性惊厥性（90%）。ivLEV 对大约一半的患者（57.5%）有效，平均时间为 14.4 小时。ivLEV 在 26 例患者中作为附加治疗（在苯二氮䓬类药物加苯妥英钠、丙戊酸钠或两者之后），有效率为 46.1%，在 14 例患者中作为早期治疗（在使用苯二氮䓬类药物之前或不使用），有效率为 78.5%（p<0.048）。观察到 15%的患者出现不良反应。
ivLEV 是一种有效的治疗 SE 的抗癫痫药物，但疗效取决于其给药时间，早期治疗效果更好，而作为附加治疗效果较差。
