title: Comparison of Antiepileptic Approaches in Treatment of Benzodiazepine Nonresponsive Status Epilepticus.
abstract: OBJECTIVE
  Status epilepticus and seizure clusters are common neurological emergencies. The purpose of this monocentric, retrospective cohort study was to comparatively assess different antiepileptic approaches in the treatment of status epilepticus and seizure clusters, which were nonresponsive to benzodiazepines.
  
  
  METHODS
  We reviewed medical records of 66 patients, who were treated for status epilepticus or seizure clusters in the Department of Neurology at the University of the Saarland between January 2007 and July 2012, and failed to respond to benzodiazepines with the equivalent dosage of at least 20 mg of diazepam. As endpoints, we analyzed both the effectiveness of lacosamide, levetiracetam, valproic acid, and phenytoin used as second- and third-line therapy, and the Glasgow Outcome Scale at day 7.
  
  
  RESULTS
  Sixty-one (92.4%) of the patients had status epilepticus, and 5 (7.6%) had seizure clusters. The compared drugs were equally effective in terminating seizures. There was also no significant difference in the Glasgow Outcome Scale (P = 0.60) after 7 days.
  
  
  CONCLUSIONS
  Our data support the use of the modern antiepileptic treatment strategies, such as levetiracetam, valproic acid, and lacosamide in the treatment of status epilepticus and seizure clusters.
authors: Department of Neurology, University of the Saarland, Homburg, Germany.
authors: Armin
authors: A
authors: Bachhuber
authors: Department of Neurology, University of the Saarland, Homburg, Germany.
authors: Maike
authors: M
authors: Lasrich
authors: Department of Neurology, University of the Saarland, Homburg, Germany.
authors: Ramona
authors: R
authors: Halmer
authors: Department of Neurology, University of the Saarland, Homburg, Germany.
authors: Klaus
authors: K
authors: Fassbender
authors: Department of Neurology, University of the Saarland, Homburg, Germany.
authors: Silke
authors: S
authors: Walter
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000927:Anticonvulsants / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000009:adverse effects*; D000069279:Drug Resistant Epilepsy / Q000188:drug therapy*; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013226:Status Epilepticus / Q000175:diagnosis / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D001569:Benzodiazepines
keywords: Glasgow Outcome Scale; Lacosamide; Levetiracetam; Phenytoin; Valproic acid