Department of Neurology, Klinikum Osnabrück, Osnabrueck, Germany.
Acta Neurol Scand. 2014 May;129(5):294-9. doi: 10.1111/ane.12174. Epub 2013 Aug 13.
To compare intravenous phenytoin (PHT) and intravenous lacosamide (LCM) for treatment of status epilepticus after failure of the first and second drug.
We retrospectively identified patients from a large community hospital in northern Germany who had been diagnosed with SE between August 2008 and December 2010. Patients who had failed to respond to the first two drugs were selected for this analysis.
Forty-six patients (23 female, median age 68 years) were identified. LCM was used as third drug in 21 patients (median bolus 400 mg) and PHT in 15 patients (median bolus 1500 mg). Pretreatment was similar regarding substance groups (benzodiazepine as first line, levetiracetam as second line drug) and bolus doses. Status epilepticus was terminated in six patients (40%) of the PHT group and in seven patients (33%) of the LCM group. Four patients (27%) of the PHT group and no patient of the LCM group suffered from a relevant, treatment-related side effect during administration of the third drug.
Lacosamide and PHT showed similar success rates for treatment of SE when used after failure of benzodiazepines and levetiracetam. However, PHT was associated with relevant side effects that were not seen with LCM.
比较苯妥英钠（PHT）和拉考酰胺（LCM）静脉注射治疗一线和二线药物治疗失败后的癫痫持续状态（SE）。
我们回顾性地从德国北部的一家大型社区医院中确定了 2008 年 8 月至 2010 年 12 月期间被诊断为 SE 的患者。选择对前两种药物无反应的患者进行此分析。
确定了 46 名患者（23 名女性，中位年龄 68 岁）。21 名患者（中位剂量 400mg）使用 LCM 作为第三种药物，15 名患者（中位剂量 1500mg）使用 PHT。在药物种类（苯二氮䓬类作为一线治疗，左乙拉西坦作为二线药物）和推注剂量方面，预处理相似。在 PHT 组中有 6 名（40%）患者和 LCM 组中有 7 名（33%）患者终止了 SE。在接受第三种药物治疗时，PHT 组中有 4 名（27%）患者和 LCM 组中无患者出现与治疗相关的不良反应。
在苯二氮䓬类和左乙拉西坦治疗失败后，拉考酰胺和苯妥英钠治疗 SE 的成功率相似。然而，PHT 与相关的不良反应相关，而 LCM 则没有。
