Abstracts

Rationale: The use of new antiepileptic drugs in bensodiazepine-resistant status epilepticus where phenytoin is deemed inappropriate due to allergy or comorbidity is getting increasing attention. Levetiracetam (LEV)is a new AED with few side-effects and is easy to administer. We wanted to clarify the aivailable litterature on LEV as a first line AED in the treatment of status epilepticus.Methods: An online MEDLINE search yielded 118 articles. The abstracts were screened for studies where LEV had been administered intravenously as the first AED, on its own or together with bensodiazepines. After application of inclusion criteria, eight studies remained.Results: Six studies were retrospective observational and two prospective observational. The studies contained 119 relevant patients, 76% of which had suffered partial SE. The efficacy ranged from 44% to 100%, with higher efficacy reported in the retrospective studies.Conclusions: The evidence for use of LEV as a first line AED in status epilepticus is limited.The higher efficacy in the retrospective studies might indicate publication bias. Caution is needed when interpreting the retrospective studies in clinical decision making.