Intravenous levetiracetam of hospitalized patients in Srinagarind Hospital

Levetiracetam (LEV) is a fairly new antiepileptic drug with broad effectiveness in controlling seizures. Presently, there is limited clinical data worldwide. This study aims to add more clinical efficacy and safety data for intravenous LEV. Chart review was done in patients who received intravenous LEV at Srinagarind Hospital, Khon Kaen University, Thailand from August, 2010 to June, 2012. There were 48 prescriptions on 46 patients with a mean age of 56.75 years. The three most common causes of seizures were metabolic derangement, renal dysfunction, and hypoxic ischemic encephalopathy. Intravenous LEV was used for status epilepticus (SE) for 34 out of 48 prescriptions (70.8%) and non-SE 14 times (29.2%). The loading and maintenance doses of intravenous LEV were 1520.60 mg (range 1000 to 6500) and 1171.70 mg/day (500 to 3000). Seizure was controlled by intravenous LEV in 21 out of 34 prescriptions with SE (61.8%) and all patients with non-SE (100%). The overall mortality rate was 45.7% (21 out of 46 patients). The most common cause of death was sepsis with multiple organ failure (17 out of 21 patients or 81%). There was no obvious side effect of intravenous LEV in any patient. Intravenous LEV is effective and safe in seizure control particularly in patients with renal and liver dysfunction who had either SE or non-SE.   Key words: Levetiracetam, efficacy, safety, status epilepticus.