Open AccessComparison of Antiepileptic Approaches in Treatment of Benzodiazepine Nonresponsive Status Epilepticus
Author(s) -
Bachhuber Armin,
Lasrich Maike,
Halmer Ramona,
Fassbender Klaus,
Walter Silke
Publication year - 2016
Publication title -
cns neuroscience and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.403
H-Index - 69
eISSN - 1755-5949
pISSN - 1755-5930
DOI - 10.1111/cns.12389
Subject(s) - lacosamide , status epilepticus , levetiracetam , medicine , benzodiazepine , valproic acid , phenytoin , epilepsy , anesthesia , diazepam , retrospective cohort study , pediatrics , psychiatry , receptor
Summary Aims 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. Conclusion 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.