title: Efficacy of intravenous levetiracetam as an add-on treatment in status epilepticus: a multicentric observational study.
abstract: BACKGROUND
  Treatment of status epilepticus (SE) has not changed in the last few decades, benzodiazepines plus phenytoin being the most common first line treatment. Intravenous levetiracetam (ivLEV) is a new antiepileptic drug with interesting properties for SE.
  
  
  METHODS
  Efficacy and effectiveness of ivLEV in SE were assessed in an observational, multicentric and retrospective study. Efficacy was defined as cessation of seizures in the 24h subsequent to starting ivLEV, with no need of any further antiepileptic drug. All patients were treated following the standard protocol (benzodiazepines plus phenytoin or valproate). ivLEV was used as add-on therapy, except in those cases with contraindication for the standard protocol, when it was administered earlier.
  
  
  RESULTS
  40 patients were included, 57% men, with a mean age of 63 years. The most common type of SE was partial convulsive (90%). ivLEV was effective in approximately half of the patients (57.5%), in a mean time of 14.4h. ivLEV was used as add-on treatment in 26 patients (after benzodiazepines plus phenytoin, valproate or both) with an efficacy of 46.1%, and as early treatment (pretreatment with benzodiazepines or nothing) in 14 patients with an efficacy of 78.5% (p 0.048). Adverse events were observed in 15% of patients.
  
  
  CONCLUSIONS
  ivLEV was an effective antiepileptic drug for SE, but its efficacy depends on the timing of its administration, being more effective when used as early treatment, and less effective as add-on treatment.
authors.affiliation: Hospital de Bellvitge, Feixa Llarga s/n, Hospitalet de Llobregat, 08907 Barcelona, Spain. 37785mam@comb.cat
authors.forename: Maria
authors.initials: M
authors.lastname: Aiguabella
authors.forename: Mercè
authors.initials: M
authors.lastname: Falip
authors.forename: Vicente
authors.initials: V
authors.lastname: Villanueva
authors.forename: Pilar
authors.initials: P
authors.lastname: de la Peña
authors.forename: Albert
authors.initials: A
authors.lastname: Molins
authors.forename: Irene
authors.initials: I
authors.lastname: Garcia-Morales
authors.forename: Rosa Ana
authors.initials: RA
authors.lastname: Saiz
authors.forename: Julio
authors.initials: J
authors.lastname: Pardo
authors.forename: Diego
authors.initials: D
authors.lastname: Tortosa
authors.forename: Gemma
authors.initials: G
authors.lastname: Sansa
authors.forename: Júlia
authors.initials: J
authors.lastname: Miró
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D000077287:Levetiracetam; D008297:Male; D008875:Middle Aged; D010889:Piracetam / Q000008:administration & dosage / Q000031:analogs & derivatives*; D012189:Retrospective Studies; D013226:Status Epilepticus / Q000188:drug therapy* / Q000503:physiopathology; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D000077287:Levetiracetam; D010889:Piracetam