Abstracts

Rationale:
This study retrospectively analyzes the management of status epilepticus and refractory status epilepticus(SE and RSE) at Tufts Medical Center and specifically evaluated the utility of Phenytoin as a treatment among the multiple and newer anti-seizure medications (AEDs). The study compared clinical data and outcomes of patients who received Phenytoin as part of their treatment regimen versus cases that did not receive Phenytoin. The efficacy of Phenytoin as a first-line therapy, and or after multiple AEDs was reviewed. This study attempts to evaluate the role of Phenytoin within a multi-drug regimen for the management of SE and RSE at our medical center.
Method:
After IRB approval, a retrospective database was created to review patients diagnosed with status epilepticus at Tufts Medical Center in Boston MA from 2015-present. Multiple clinicopathologic variables and medications were tabulated in 80 patients and an analysis was performed to profile Phenytoin´s use and effectiveness in this population
Results:
This study indicates that despite the availability of multiple AEDS, Phenytoin may terminate SE as both first line therapy and as a later choice. There were cases noted in which SE was terminated with phenytoin after multiple drug regimens were previously attempted.
Conclusion:
The clinical challenge in managing SE is finding which medication or combinations of drugs will effectively terminate SE with an appropriate side effect profile. Phenytoin is widely available and a relatively inexpensive older AED which, among all of the currently available options, including the newer AEDs, could still prove to be an integral part of seizure management in the acute setting. This study highlights that there may be a subset of patients whose SE could be terminated by phenytoin despite administration of numerous prior AEDs.
Funding:
:NONE