Wells Geoffrey Howard, Mason Louise D, Foreman Emma, Chambers John
Department of Palliative Medicine, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK.
Pharmacy Department, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK.
Age Ageing. 2016 Mar;45(2):321-2. doi: 10.1093/ageing/afv195. Epub 2016 Jan 6.
We report the case of a man who developed seizures on a background of recurrent metastatic squamous cell carcinoma with intracranial involvement. Initial seizure control with enteral levetiracetam was achieved, and when enteral and intravenous (i.v.) access was no longer available, a continuous subcutaneous infusion (CSCI) of levetiracetam successfully controlled his seizures without the need for sedating anticonvulsants. As a result, end-of-life care was able to be given with the patient retaining the ability to communicate with his family and healthcare staff. This report adds to the sparse but growing evidence base for the use of subcutaneous levetiracetam to manage seizures in palliative and end-of-life care.
我们报告了一例男性患者，其在复发性转移性鳞状细胞癌伴颅内受累的背景下出现癫痫发作。最初通过肠内左乙拉西坦实现了癫痫控制，当无法再进行肠内和静脉（i.v.）给药时，左乙拉西坦持续皮下输注（CSCI）成功控制了他的癫痫发作，而无需使用镇静性抗惊厥药物。结果，在患者仍保留与家人和医护人员沟通能力的情况下，得以提供临终关怀。本报告为在姑息治疗和临终关怀中使用皮下左乙拉西坦治疗癫痫增加了虽少但不断增长的证据基础。
