title: Effect of levetiracetam in acute encephalitis with refractory, repetitive partial seizures during acute and chronic phase.
abstract: OBJECTIVE
  To clarify the effect of levetiracetam (LEV) for acute and chronic seizure control in acute encephalitis with refractory, repetitive partial seizures (AERRPS).
  
  
  METHODS
  We retrospectively reviewed the clinical course of six AERRPS cases treated with LEV, and explored the acute phase termination by withdrawal from barbiturate-induced coma under artificial ventilation, and the reduction in seizure frequency during the chronic phase. LEV was administrated orally or via nasogastric tubes as an add-on agent during acute (n=3; age 8-10 years) and chronic (n=3; age 19-30 years) AERRPS.
  
  
  RESULTS
  In the acute phase, administration of LEV (50-60 mg/kg/d) in combination with phenobarbital (n=3; peak 57.9-76.1 μg/ml) and potassium bromide (n=2; 30-36 mg/kg/d)) resulted in successful reduction of intravenous barbiturate dosage and withdrawal from artificial ventilation. In the chronic phase, seizure frequency reduced by >75% for 5-18 months with LEV 750-1500 mg/d.
  
  
  CONCLUSIONS
  LEV may affect seizure control in AERRPS, particularly during the chronic phase, through its unique action of inhibition of excitatory neurotransmitter release. The regimen of oral barbiturate, potassium bromide and LEV would be worth for trial during the acute phase of AERRPS.
authors.affiliation: Division of Child Neurology, Institute of Neurological Sciences, Faculty of Medicine, Tottori Univesity, Yonago, Japan.
authors.forename: Riyo
authors.initials: R
authors.lastname: Ueda
authors.affiliation: Division of Child Neurology, Institute of Neurological Sciences, Faculty of Medicine, Tottori Univesity, Yonago, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Saito
authors.affiliation: Division of Child Neurology, Institute of Neurological Sciences, Faculty of Medicine, Tottori Univesity, Yonago, Japan.
authors.forename: Koyo
authors.initials: K
authors.lastname: Ohno
authors.affiliation: Department of Pediatrics, Gifu Prefectural General Medical Center, Gifu, Japan.
authors.forename: Kanako
authors.initials: K
authors.lastname: Maruta
authors.affiliation: Department of Pediatrics, Gifu Prefectural General Medical Center, Gifu, Japan.
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Matsunami
authors.affiliation: Division of Child Neurology, Institute of Neurological Sciences, Faculty of Medicine, Tottori Univesity, Yonago, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Saiki
authors.affiliation: Division of Child Neurology, Institute of Neurological Sciences, Faculty of Medicine, Tottori Univesity, Yonago, Japan.
authors.forename: Tatsuyuki
authors.initials: T
authors.lastname: Sokota
authors.affiliation: Division of Child Neurology, Institute of Neurological Sciences, Faculty of Medicine, Tottori Univesity, Yonago, Japan.
authors.forename: Susumu
authors.initials: S
authors.lastname: Sugihara
authors.affiliation: Division of Child Neurology, Institute of Neurological Sciences, Faculty of Medicine, Tottori Univesity, Yonago, Japan.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Nishimura
authors.affiliation: Division of Child Neurology, Institute of Neurological Sciences, Faculty of Medicine, Tottori Univesity, Yonago, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Tamasaki
authors.affiliation: Division of Child Neurology, Institute of Neurological Sciences, Faculty of Medicine, Tottori Univesity, Yonago, Japan.
authors.forename: Aya
authors.initials: A
authors.lastname: Narita
authors.affiliation: Department of Pediatrics, Gifu Prefectural General Medical Center, Gifu, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Imamura
authors.affiliation: Division of Child Neurology, Institute of Neurological Sciences, Faculty of Medicine, Tottori Univesity, Yonago, Japan. Electronic address: maegaki@med.tottori-u.ac.jp.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Maegaki
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use*; D001965:Bromides / Q000627:therapeutic use; D002648:Child; D002908:Chronic Disease; D004660:Encephalitis / Q000188:drug therapy* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D000077287:Levetiracetam; D008297:Male; D010634:Phenobarbital / Q000627:therapeutic use; D010889:Piracetam / Q000031:analogs & derivatives* / Q000627:therapeutic use; D017680:Potassium Compounds / Q000627:therapeutic use; D012189:Retrospective Studies; D012640:Seizures / Q000188:drug therapy* / Q000517:prevention & control; D013226:Status Epilepticus / Q000188:drug therapy* / Q000517:prevention & control; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D001965:Bromides; D017680:Potassium Compounds; D000077287:Levetiracetam; C039004:potassium bromide; D010634:Phenobarbital; D010889:Piracetam
keywords: Barbiturate coma; Febrile infection-related epilepsy syndrome; Levetiracetam; Status epilepticus