Department of Pediatrics, Division of Pediatric Neurology, Texas A&M Health Science Center College of Medicine, Scott & White Hospital , Temple, TX , USA.
Front Neurol. 2013 Aug 14;4:120. doi: 10.3389/fneur.2013.00120. eCollection 2013.
Intractable epilepsy in children poses a serious medical challenge. Acute repetitive seizures and status epilepticus leads to frequent emergency room visits and hospital admissions. Delay of treatment may lead to resistance to the first-line anticonvulsant therapies. It has been shown that these children continue to remain intractable even after acute seizure management with approved Food and Drug Administration (FDA) agents. Intravenous levetiracetam, a second-generation anticonvulsant was approved by the FDA in 2006 in patients 16 years and older as an alternative when oral treatment is not an option. Data have been published showing that intravenous levetiracetam is safe and efficacious, and can be used in an acute inpatient setting. This current review will discuss the recent data about the safety and tolerability of intravenous levetiracetam in children and neonates, and emphasize the need for a larger prospective multicenter trial to prove the efficacy of this agent in acute seizure management.
儿童难治性癫痫是一个严峻的医学挑战。急性反复发作性癫痫和癫痫持续状态导致频繁到急诊室就诊和住院。治疗的延误可能导致对一线抗癫痫治疗产生耐药性。已经表明,即使在使用经美国食品药品监督管理局(FDA)批准的药物进行急性癫痫发作管理后,这些儿童仍持续为难治性癫痫。左乙拉西坦是第二代抗癫痫药,于 2006 年被 FDA 批准用于 16 岁及以上患者,作为口服治疗不可行时的替代药物。已经发表的数据表明,静脉用左乙拉西坦是安全有效的,可在急性住院环境中使用。本综述将讨论最近关于儿童和新生儿静脉用左乙拉西坦的安全性和耐受性的数据,并强调需要进行更大规模的前瞻性多中心试验,以证明该药物在急性癫痫发作管理中的疗效。