Erfahrungen mit Levetiracetam in der Behandlung des Status epilepticus

Zusammenfassung

Für den nonkonvulsiven Status epilepticus (NKSE) und die Epilepsia partialis continua (EPC) sind die therapeutischen Empfehlungen in den meisten Leitlinien nicht so eindeutig wie für den Status generalisierter tonisch-klonischer Anfälle (GTKSE). NKSE und EPC sind aber nicht selten therapierefraktär. Daher kommen hier gelegentlich auch Substanzen zum Einsatz, die über keine Zulassung für die Behandlung eines Status epilepticus (SE) verfügen. Im Rahmen dieser Übersichtsarbeit wurden die bis zum 12.12.2011 in Pub-med gelisteten Fallberichte und Fallserien zur Levetiracetam(LEV)-Anwendung bei unterschiedlichen Formen des SE – ergänzt um durch Literaturverweise gefundene Arbeiten und Abstracts in peer-reviewed-Journals – analysiert. Um den Publikationsbias zu reduzieren, wurden zusätzlich Arbeiten in die Analyse einbezogen, die über Lacosamid(LCM)-Anwendung bei Formen des SE berichten. LEV wurde in Dosen von 500 – 9000 mg eingesetzt. An Nebenwirkungen wurden insbesondere Sedierung und Reizbarkeit berichtet. Mit einer auf Basis der Fallserien geschätzten Gesamterfolgsrate von 53,7 – 58,1 % scheint LEV eine mögliche Behandlungsoption eines SE bei bestehenden Kontraindikationen für etablierte Therapieverfahren oder nach deren erfolglosem Einsatz zu sein.

Abstract

Non-convulsive status epilepticus and epilepsia partialis continua are common epileptic conditions for which straightforward recommendations based on controlled randomised trials for treatment of therapy refractory courses are lacking. Therefore in these conditions sometimes antiepileptic drugs that are not approved by governmental authorities for the treatment of status epilepticus (SE) are used. Here we review all case reports and case series concerning the treatment of SE with levetiracetam (LEV), that had been listed in pub-med up to December 12th 2011. Additionally we analysed abstracts and papers in peer reviewed journals, that were listed in the references of the primarily reviewed papers. Furthermore we looked for LEV treatments in papers on the use of lacosamide (LCM) in SE. LEV was given in dosages ranging from 500 mg to 9000 mg per day. Side effects were especially sedation and irritability. Estimated on the basis of the case series the overall success-rate of LEV in terminating status epilepticus may be set in a range between 53.7 % and 58.1 %. Therefore LEV may be a useful alternative for the treatment of SE when the approved drugs are contraindicated or when these drugs have been taken without success.

Schlüsselwörter

Status epilepticus - Levetiracetam - Erfolgsrate - Alterseinfluss

Key words

status epilepticus - levetiracetam - success rates - influence of age

• Literatur

• 1 Rosenow F, Hamer HM, Knake S. The epidemiology of convulsive and nonconvulsive status epilepticus. Epilepsia 2007; 48 (Suppl. 08) 82-84
• 2 Kälviäinen R. Status epilepticus treatment guidelines. Epilepsia 2007; 48 (Suppl. 08) 99-102
• 3 Kurthen M, Janzen RWC, Lerche H et al. Leitlinien der DGN – Status epilepticus im Erwachsenenalter. http://www.dgn.org/inhalte-a-z/507-leitlinien-der-dgn-status-epilepticus-im-erwachsenenalter (3.7.2011)
• 4 Shorvon S, Baulac M, Cross H et al. The drug treatment of status epilepticus in Europe: Consensus document from a workshop at the first London Colloquium on Status Epilepticus. Epilepsia 2008; 49: 1277-1284
• 5 Meierkord M, Boon P, Engelsen B et al. EFNS guideline on the management of status epilepticus in adults. Eur J Neurol 2010; 17: 348-355
• 6 Trinka E, Dobesberger J. New treatment options in status epilepticus: a critical review on intravenous levetiracetam. Ther Adv Neurol mDisord 2009; 2: 79-91
• 7 Arrigo A, Raiteri U, Ardizzone G. Levetiracetam monotherapy for the treatment of partial status epilepticus in a patient following a liver transplant. Epilpesia 2004; 45 (Suppl. 03) 145
• 8 Zaatreh MM. Levetiracetam in porphyric status epilepticus: a case report. Clin Neuropharmacol 2005; 28: 243-244
• 9 Pato-Pato A, Rana-Martinez N, Lorenzo-Gonzáles JR et al. The value of an oral solution of levetiracetam in status epilepticus. Rev Neurol 2006; 42: 768
• 10 Donaire A, Carreno M, Gómez B. Cortical laminar necrosis related to prolonged focal status epilepticus. J Neurol Neurosurg Psychiatry 2006; 77: 104-106
• 11 Feleppa MMF, De Cillis PPDC, Esposito GGE. Refractory status epilepticus treated by nasogastric levetiracetam: a case report of excellent neurological recovery. Epilepsia 2006; 47 (Suppl. 04) 158
• 12 Veldkamp AI, Swart EL. Unanticipated recovery from a status epilepticus after administration of levetiracetam. Br J Clin Pharmacol 2006; 62: 734-735
• 13 Pastor-Milán E, González-Torres V, Vilches R. Utilidad del levetiracetam en el estado epiléptico. Rev Neurol 2006; 41: 508-509
• 14 Shoemaker MT, Rotenburg JS. Levetiracetam for the treatment of neonatal seizures. J Child Neurol 2007; 22: 95-98
• 15 Farooq MU, Naravetla B, Majid A et al. IV levetiracetam in the management of non-convulsive status epilepticus. Neurocrit Care 2007; 7: 36-39
• 16 Trabacca A, Profice P, Costanza MC et al. Levetiracetam in nonconvulsive status epilepticus in childhood: a case report. J Child Neurol 2007; 22: 639-641
• 17 Zenkov LR, Shevtsov KI, Gubanova NB. Levetiracetam (keppra) in the treatment of refractory status epilepticus. Zh Nevrol Psikhiatr Im S S Korsakova 2007; 107: 71-74
• 18 Alehan F, Ozcay F, Haberal M. The use of levetiracetam in a child with nonconvulsive status epilepticus. J Child Neurol 2008; 23: 331-333
• 19 Goraya JS, Khurana DS, Valencia I et al. Intravenous levetiracetam in children with epilepsy. Pediatr Neurol 2008; 38: 177-180
• 20 Bhatia R, Vibha D, Srivastava MV et al. Use of propofol anesthesia and adjunctive treatment with levetiracetam and gabapentin in managing status epilepticus in a patient of acute intermittent porphyria. Epilepsia 2008; 49: 934-936
• 21 Altenmüller DM, Kühn A, Surges R et al. Termination of absence status epilepticus by low-dose intravenous levetiracetam. Epilepsia 2008; 49: 1289-1290
• 22 Callén-Soto A, Pérez-Pérez S, Robles-Del Olmo B. Non-convulsive epileptic status reverted with intravenous levetiracetam. Rev Neurol 2008; 47: 501-502
• 23 Abend NS, Florance N, Finkel RS et al. Intravenous levetiracetam terminates refractory focal status epilepticus. Neurocrit Care 2009; 10: 83-86
• 24 Carota A, Novy J, Rossetti AO. Symptomatic complex partial status epilepticus manifesting as utilization behavior of a mobile phone. Epilepsy & Behavior 2009; 14: 553-555
• 25 Elouni B, Salem CB, Biour M. Levetiracetam-induced pancytopenia. Ann Pharm 2009; 43: 985
• 26 Cilio MR, Bianchi R, Balestri M et al. Intravenous levetiracetam terminates refractory status epilepticus in two patients with migrating partial seizures in infancy. Epilepsy Res 2009; 86: 66-71
• 27 Pestana Knight EM, Gilman S, Selwa L. Status epilepticus in Wilson’s disease. Epileptic Disord 2009; 11: 138-143
• 28 Haase CG, Hopmann B. Epilepsia partialis continua successfully treated with levetiracetam. J Neurol 2009; 256: 1020-1021
• 29 Haberlandt E, Sigl SB, Scholl-Buergi S et al. Levetiracetam in the treatment oft two children with myoclonic status epilepticus. Eur J Paediatr Neurol 2009; 13: 546-549
• 30 Schulze-Bonhage A, Hefft S, Oehl B. Termination of complex partial status epilepticus by intravenous levetiracetam. J Neurol Neurosurg Psychiatry 2009; 80: 931-933
• 31 Eggers C, Burghaus L, Fink GR et al. Epilepsia partialis continua responsive to intravenous levetiracetam. Seizure 2009; 18: 716-718
• 32 Weber P. Levetiracetam in nonconvulsive status epilepticus in a child with Angelman syndrome. J Child Neurol 2010; 25: 393-396
• 33 Da-Silva SS, Wong R, Coquillon P. Partial-exchange transfusion: an effective method for preventing mortality in a child with propofol infusion syndrome. Pediatrics 2010; 125: e1493-e1499
• 34 Turpin-Fenoll L, Millan-Pascual J, Navarro-Munoz S et al. Uso de lacosamida oral en un paciente con estado epileptico parcial refractario. Rev Neurol 2010; 50: 603-606
• 35 Patil HV, Patil VC, Rajmane V et al. Successful treatment of cerebral toxoplasmosis with cotrimoxazole. Indian J Sex Transm Dis 2011; 32: 44-46
• 36 Devarajan J, Siyam AM, Alexopoulos AV et al. Non-convulsive status epilepticus in the postanesthesia care unit following meningioma excision. Can J Anesth 2011; 58: 68-73
• 37 Chen LLK, Haneef Z, Dorsch A et al. Successful treatment of refractory simple motor status epilepticus with lacosamide and levetiracetam. Seizure 2011; 20: 263-265
• 38 Krause LU, Brodowski KO, Kellinghaus C. Atrioventricular block following lacosamide intoxication. Epilepsy & Behavior 2011; 20: 725-727
• 39 Laroche SM, Shivdat-Nanhoe R. Subacute encephalopathy and seizures in alcoholics (SESA) presenting with non-convulsive status epilepticus. Seizure 2011; 20: 505-508
• 40 Shiloh-Malawsky Y, Fan Z, Greenwood R et al. Successful treatment of childhood prolonged refractory status epilepticus with lacosamide. Seizure 2011; 20: 586-588
• 41 Torres-Cano N, Giner-Bayarri P, Chilet-Chilet MR et al. Estado epileptico non convulsive persistente. Rev Neurol 2011; 53: 255-256
• 42 Ko SB, Ortega-Gutierrez S, Choi HA et al. Status Epilepticus-induced hyperemia and brain tissue hypoxia after cardiac arrest. Arch Neurol 2011; 68: 1323-1326
• 43 Rossetti AO, Bromfield EB. Levetiracetam in the treatment of status epilepticus in adults: a study of 13 episodes. Eur Neurol 2005; 54: 34-38
• 44 Mehta S, Wu BY. Case Series: Treatment with levetiracetam in nonconvulsive status epilepticus. Epilepsia 2005; 46 (Suppl. 08) 220
• 45 Saguer M, Estermann K, Caravias G et al. Treatment in SE (status epilepticus) in ICU with levetiracetam. Neurology 2006; 66 (Suppl. 02) p A38
• 46 Patel NC, Landan IR, Levin J et al. The use of levetiracetam in refractory status epilepticus. Seizure 2006; 15: 137-141
• 47 Rossetti AO, Bromfield EB. Determinants of success in the use of oral levetiracetam in status epilepticus. Epilepsy Behav 2006; 8: 651-654
• 48 Falip M, Carreno M, Amaro S et al. Use of levetiracetam in hospitalized patients. Epilepsia 2006; 47: 2186-2188
• 49 Rupprecht S, Franke K, Fitzek S et al. Levetiracetam as a treatment option in non-convulsive status epilepticus. Epilepsy Res 2007; 73: 238-244
• 50 Reinshagen A, Holler M, Fritz K et al. Intravenous levetiracetam in refractory status epilepticus: case reports. Epilepsia 2007; 48 (Suppl. 03) 20
• 51 Seminario NA, Bateman LM, Seyal M. The use of intravenous levetiracetam for status epilepticus. Epilepsia 2007; 48 (Suppl. 06) 36
• 52 Khongkhatithum C, Goyal M. Use of intravenous levetiracetam in a pediatric tertiary care hospital. Epilsepsia 2007; 48 (Suppl. 06) 354
• 53 Morton L, Powers K, Teasley J. Use of intravenous (iv) levetiracetam in 3 cases of refractory status epilepticus (SE) in pediatric patients. Epilepsia 2007; 48 (Suppl. 06) 357-358
• 54 Broessner G, Dobesberger J, Seppi K et al. Intravenous levetiracetam in seizure emergency situations including status epilepticus. Epilepsia 2007; 48 (Suppl. 08) 103-104
• 55 Rüegg S, Naegelin Y, Hardmeier M et al. Intravenous levetiracetam: treatment experience with the first 50 critically ill patients. Epilepsy Behav 2008; 12: 477-480
• 56 Knake S, Gruener J, Hattemer K et al. Intravenous levetiracetam in the treatment of benzodiazepine refractory status epilepticus. J Neurol Neurosurg Psychiatry 2008; 79: 588-589
• 57 Eckert M, Besser R. Rapid intravenous infusion of levetiracetam. Akt Neurol 2008; 35: 211-213
• 58 Gallentine WB, Hunnicutt AS, Husain AM. Levetiracetam in children with refractory status epilepticus. Epilepsy Behav 2009; 14: 215-218
• 59 Beyenburg S, Reuber M, Maraite N. Intravenous levetiracetam for epileptic seizure emergencies in older people. Gerontology 2009; 55: 27-31
• 60 Nau KM, Divertie GD, Valentino AK et al. Safety and efficacy of levetiracetam for critically ill patients with seizures. Neurocrit Care 2009; 11: 34-37
• 61 Uges JW, van Huizen MD, Engelsman J et al. Safety and pharmacokinetics of intravenous levetiracetam infusion as add-on in status epilepticus. Epilepsia 2009; 50: 415-421
• 62 Möddel G, Bunten S, Dobis C et al. intravenous levetiracetam: a new treatment alternative for refractory status epilepticus. J Neurol Neurosurg Psychiatry 2009; 80: 689-692
• 63 Kirmani BF, Crisp ED, Kayani S et al. Role of intravenous levetiracetam in acute seizure management of children. Pediatr Neurol 2009; 41: 37-39
• 64 Abend NS, Monk HM, Licht DJ et al. Intravenous levetiracetam in critically ill children with status epilepticus or acute repetitive seizures. Pediatr Crit Care Med 2009; 10: 505-510
• 65 Eue S, Grumbt M, Müller M et al. Two years of experience in the treatment of status epilepticus with intravenous levetiracetam. Epilepsy Behav 2009; 15: 467-469
• 66 Berning S, Boesebeck F, van Baalen A et al. Intravenous levetiracetam as treatment for status epilepticus. J Neurol 2009; 256: 1634-1642
• 67 Gámez-Leyva G, Aristín JL, Fernández E et al. Experience with intravenous levetiracetam in status epilepticus: a retrospective case series. CNS Drugs 2009; 23: 983-987
• 68 Tripathi M, Vibha D, Choudhary N. Management of refractory status epilepticus at a tertiary care centre in a developing country. Seizure 2010; 19: 109-111
• 69 Abend NS, Dlugos DJ, Hahn CD et al. Use of EEG monitoring and management of non-convulsive seizures in critically ill patients: a survey of neurologists. Neurocrit Care 2010; 12: 382-389
• 70 Fattouch J, Di Bonaventura C, Casciato S et al. Intravenous Levetiracetam as first-line treatment of status epilepticus in the elderly. Acta Neurol Scand 2010; 121: 418-421
• 71 Modur PN, Milteer WE, Zhang S. Sequential intrarectal diazepam and intravenous levetiracetam in treating acute repetive and prolonged seizures. Epilepsia 2010; 51: 1078-1082
• 72 Reiter PD, Huff AD, Knupp KG et al. Intravenous levetiracetam in the management of acute seizures in children. Pediatr Neurol 2010; 43: 117-121
• 73 Aiguabella M, Falip M, Villanueva V et al. Efficacy of intravenous levetiracetam as an add-on treatment in status epilepticus: a multicentric observational study. Seizure 2011; 20: 60-64
• 74 Parkerson KA, Reinsberger C, Chou SH et al. Lacosamide in the treatment of acute recurrent seizures and periodic epileptiform patterns in critically ill patients. Epilepsy & Behavior 2011; 20: 48-51
• 75 Mameniskiene R, Bast T, Bentes C et al. Clinical course and variability of non-Rasmussen, nonstroke motor and sensory epilepsia partialis continua: A European survey and analysis of 65 cases. Epilepsia 2011; 52: 1168-1176
• 76 Kellinghaus C, Berning S, Immisch I et al. Intravenous lacosamide for treatment of status epilepticus. Acta Neurol Scand 2011; 123: 137-141
• 77 Koubeissi MZ, Mayor CL, Estephan B et al. Efficacy and safety of intravenous lacosamide in refractory nonconvulsive status epilepticus. Acta Neurol Scand 2011; 123: 142-146
• 78 Albers JM, Möddel G, Dittrich R et al. Intravenous lacosamide – an effective add-on treatment of refractory status epilepticus. Seizure 2011; 20: 428-430
• 79 Goodwin H, Hinson HE, Shermock KM et al. The use of lacosamide in refractory status epilepticus. Neurocrit Care 2011; 14: 348-353
• 80 Alvarez V, Januel JM, Burnand B et al. Second-line status epilepticus treatment: Comparison of phenytoin, valproate, and levetiracetam. Epilepsia 2011; 52: 1292-1296
• 81 Rantsch K, Walter U, Wittstock M et al. Efficacy of intravenous lacosamide in refractory nonconvulsive status epilepticus and simple partial status epilepticus. Seizure 2011; 20: 529-532
• 82 Swisher CB, Doreswamy M, Gingrich KJ et al. Phenytoin, levetiracetam, and pregabalin in the acute management of refractory status epilepticus in patients with brain tumors. Neurocrit Care 2012; 16: 109-113
• 83 Misra UK, Kalita J, Maurya PK. Levetiracetam versus lorazepam in status epilepticus: a randomized, open labeled pilot study. J Neurol 2012; 259: 645-648
• 84 Eriksson K, Metsäranta P, Huhtala H et al. Treatment delay and the risk of prolonged status epilepticus. Neurology 2005; 65: 1316-1318
• 85 DeLorenzo RJ, Towne AR, Pellock JM et al. Status epilepticus in children, adults, and the elderly. Epilepsia 1992; 33 (Suppl. 04) 15-25
• 86 Towne AR, Pellock JM, Ko D et al. Determinants of mortality in status epilepticus. Epilepsia 1994; 35: 27-34
• 87 Rossetti AO, Logroscino G, Milligan TA et al. Status Epilepticus Severity Score (STESS). A tool to orient early treatment strategy. J Neurol 2008; 255: 1561-1566
• 88 Trinka E. What is the relative value of the standard anticonvulsants: Phenytoin and fosphenytoin, Phenobarbital, valproate, and levetiracetam?. Epilepsia 2009; 50 (Suppl. 12) 40-43
• 89 Jaques L, Rossetti AO. Newer antiepileptic drugs in the treatment of status epilepticus: Impact on prognosis. Epilepsy Behav 2012; ahead of print.
• 90 Harden C. Safety profile of Levetiracetam. Epilepsia 2001; 42 (Suppl. 04) 36-39
• 91 Lyseng-Williamson KA. Spotlight on levetiracetam in epilepsy. CNS Drugs 2011; 25: 901-905
• 92 Fröscher W, Raape J, Rösche J. Reversibler GGT-Anstieg bei einer Levetiracetam-Kombinationstherapie. Akt Neurol 2005; 32: 537-540