Intravenous levetiracetam treatment in Thai adults with status epilepticus

Background: The clinical data for intravenous levetiracetam in status epilepticus is limited particularly in the Asian populations. This study aimed to review the clinical use, efficacy, and outcomes of intravenous levetiracetam in Thai adults with status epilepticus. Methods: Clinical data of patients who were diagnosed as status epilepticus, aged over 15 years, and who received intravenous levetiracetam were retrospectively reviewed. The study was done at Srinagarind Hospital, Khon Kaen University, Thailand. The study period was between August 2010 and June 2012. Clinical data and outcomes were studied. Factors associated with a worse outcome of intravenous levetiracetam in status epilepticus were examined. Results: There were 34 prescriptions for intravenous levetiracetam in patients with status epilepticus. Approximately half of the patients were male (18 patients) and the mean age was 58.4 (range 15-91 years). All patients had at least one co-morbidity condition. The four most common causes of SE were electrolyte abnormalities or hypoglycemia with sepsis (14), renal dysfunction (12), hypoxic ischemic encephalopathy (11), and hepatic dysfunction (6). The seizure control rate was 61.8% (21 patients). There were 14 patients (41.2%) who were alive and had improvement at the time of discharge. Compared to those with worse outcome, there was no statistical difference in age, gender, type of status epilepticus, renal dysfunction, or second-line treatment except numbers of co-morbidity conditions. The worse outcome group had significantly higher numbers of co-morbidity conditions (p value 0.036). Conclusion: Intravenous levetiracetam has good efficacy and may be a good option for status epilepticus.