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Levetiracetam in toxic seizures
Ted Lee1, Brandon J Warrick1,2, Preeyaporn Sarangarm1
1a Department of Emergency Medicine , University of New Mexico Hospital , Albuquerque , NM , USA.
Clinical Toxicology (Philadelphia, Pa.)
|July 29, 2017
Summary
Levetiracetam effectively controlled drug-induced seizures and prevented recurrence in patients unresponsive to initial treatments. This study found no adverse effects, suggesting levetiracetam (LEV) is a safe second-line therapy for managing these seizures.
Area of Science:
- Neuroscience
- Pharmacology
- Emergency Medicine
Background:
- Drug-induced seizures (DIS) are a critical medical emergency requiring effective treatment.
- Benzodiazepines are first-line, but refractory cases necessitate second-line agents.
- Levetiracetam (LEV) presents theoretical advantages for DIS due to its unique pharmacology and safety profile.
Purpose of the Study:
- To evaluate the safety and efficacy of levetiracetam (LEV) as a second-line treatment for drug-induced seizures.
- To assess the association between LEV administration and seizure cessation or recurrence prevention in DIS patients.
Main Methods:
- Retrospective chart review of 34 patients treated with LEV for DIS at a level 1 trauma center (2010-2015).
- Inclusion criteria: poisoning diagnosis, seizure diagnosis, and LEV administration.
- Exclusion criteria: alcohol withdrawal, anoxic brain injury, hypoglycemia, pseudoseizures.
- Outcomes: seizure cessation, seizure recurrence prevention, and adverse drug effects (ADE).
Main Results:
- Levetiracetam (LEV) demonstrated significant efficacy, with 79% of patients (27/34) returning to baseline health.
- In generalized convulsive status epilepticus (GCSE) patients, 65% (11/17) remained seizure-free post-LEV therapy.
- In generalized tonic-clonic seizure (TCS) patients, 94% (16/17) were seizure-free during hospitalization.
- No adverse drug effects (ADE) attributed to LEV were observed.
Conclusions:
- Levetiracetam (LEV) is a safe and effective second-line agent for managing drug-induced seizures (DIS).
- LEV is associated with seizure control and prevention of recurrence in DIS patients.
- Further prospective studies are warranted to confirm these findings.
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