Clinical Outcome of Intravenous Levetiracetam in Acute Seizure, Tertiary Care Hospital, Thailand
Lertsinudom S, BCP1,3, Lapmag A, Grad.Dip1, Tiamkao S, MD2,3, on behalf of the Integrated Epilepsy Research Group3
Affiliation : 1 Clinical Pharmacy Division, Faculty of Pharmaceutical Sciences, Khon Kaen University, Khon Kaen, Thailand 2 Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand 3 Integrated Epilepsy Research Group, Khon Kaen University, Khon Kaen, Thailand
Objective : Intravenous levetiracetam has been approved for use as an antiepileptic drug, as well as in cases of acute seizure. There
are few reports that detail the clinical data and outcomes in seizure control within 30 minutes and seizure control which is categorized
by a treatment prescription of intravenous levetiracetam.
Materials and Methods : This was a retrospective analytical study conducted at Khon Kaen University’s Srinagarind Hospital in
Thailand. The study period was between January 1, 2010 and December 31, 2014. The inclusion criteria were that patients were
over 15 years old and had received intravenous levetiracetam treatment. The main clinical outcomes were seizure control within
30 minutes and seizure control which is categorized by treatment prescription of intravenous levetiracetam. Clinical outcomes
were compared between status epilepticus and non-status epilepticus.
Results : During the study period, there were 332 patients who met the study criteria. The average age of the patients was 55.7+20.4
years with nearly equal gender distribution. Of those, 91 patients (27.4%) had status epilepticus and 241 patients (72.6%) had non-
status epilepticus. Intravenous levetiracetam was administered as the first line (after initial benzodiazepine), second line, third line
and fourth line antiepileptic drug in 192 patients (57.8%), 107 patients (32.2%), 28 patients (8.4%) and 5 patients (1.5%), respectively.
The seizure control rate within 30 minutes after administration of intravenous levetiracetam in the status epilepticus was significantly
less than in the non-status epilepticus groups (49.5%, 90%; p<0.001), but the number of patients who died in status epilepticus and
non-status epilepticus groups were not significantly different (31.9%, 33.2%; p = 0.78). The seizure control rates of acute seizure
patients who received intravenous levetiracetam in first line, second line, third line and fourth line were 86.9%, 81.3%, 57.1% and
20%, respectively.
Conclusion : Intravenous levetiracetam was effective in acute seizures especially in first line treatment.
Keywords : Levetiracetam, Seizure, Status epilepticus
