Ammar Abdalla A, Ammar Mahmoud A, Owusu Kent, Gilmore Emily J
Department of Pharmacy, Yale New Haven Health System, New Haven, Connecticut, USA
Department of Pharmacy, Yale New Haven Health System, New Haven, Connecticut, USA.
BMJ Case Rep. 2020 Nov 23;13(11):e234955. doi: 10.1136/bcr-2020-234955.
Diagnosis and management of status epilepticus (SE), including non-convulsive status epilepticus (NCSE), is challenging, with a reported 30%-50% of epilepticus patients not responding to available antiseizure medications (ASMs). Injectable benzodiazepines, fosphenytoin, valproate, levetiracetam, lacosamide and phenobarbital are commonly used for treating SE. Brivaracetam, a new ASM, with higher affinity and greater selectivity for the synaptic vesicle glycoprotein 2A than levetiracetam, has been approved as monotherapy or adjunct for treatment of focal onset seizures. Brivaracetam may have a role in the management of SE. However, limited data exist on brivaracetam's efficacy in SE. We describe a patient case with focal NCSE refractory to levetiracetam, fosphenytoin, lacosamide and valproate who demonstrated clinical and electrographic improvement on continuous electroencephalography monitoring after brivaracetam administration.
癫痫持续状态（SE），包括非惊厥性癫痫持续状态（NCSE）的诊断和管理具有挑战性，据报道，30%-50%的癫痫持续状态患者对现有的抗癫痫药物（ASM）没有反应。注射用苯二氮卓类药物、磷苯妥英、丙戊酸盐、左乙拉西坦、拉科酰胺和苯巴比妥常用于治疗SE。布立西坦是一种新型ASM，对突触囊泡糖蛋白2A的亲和力高于左乙拉西坦，选择性更强，已被批准作为单药治疗或辅助治疗局灶性发作。布立西坦可能在SE的管理中发挥作用。然而，关于布立西坦在SE中的疗效的数据有限。我们描述了一例对左乙拉西坦、磷苯妥英、拉科酰胺和丙戊酸盐难治的局灶性NCSE患者，在给予布立西坦后，连续脑电图监测显示临床和脑电图有改善。
