Subcutaneous Levetiracetam in Palliative Care Management of Seizures
Abstract number :
2.385
Submission category :
18. Case Studies
Year :
2021
Submission ID :
1825693
Source :
www.aesnet.org
Presentation date :
12/5/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:50 AM
Authors :
Laura Mora Munoz, MD - Universidad del Rosario; Mariana Gaviria Carrillo, MD - Neurologist-Professor Universidad del Rosario, Neuroscience Center Neurovitae, Universidad del Rosario; Alberto Velez Van Meerbeke, MD - Director and Professor Neuroscience Research Group, Neuroscience, Universidad del Rosario; Juliana Vargas Osorio, MD - Clinical Coordinator Epilepsy Department, Neurology Department, Universidad Militar Nueva Granada; Felipe Diaz Forero, MD - Lecturer, Neuroscience, Universidad del Rosario; Jhonatan Estrada, MD - Neurologist, Neurology Department, Hospital Naval de Cartagena; Viviana Torres Ballesteros, MD - Neurologist, Neurology department, Universidad Militar Nueva Granada; Jesús Hernán Rodríguez Quintana, MD - Professor and Chair of Neurology Universidad del Rosario, Department of Neurology, Fundación Cardioinfantil- Hospital Universitario Mayor Méderi
Rationale: Seizure control is considered a palliative care emergency. Our article generates an overview of subcutaneous levetiracetam outcomes in 20 subjects from two hospitals in Bogotá-Colombia.
Methods: We conducted a retrospective review of patients treated with subcutaneous levetiracetam in Hospital Universitario Mayor Méderi and Hospital Militar, in Bogotá, between June of 2019 and January 2021.We included adults who received subcutaneous levetiracetam during this period. Patients who continued treatment as outpatient were followed up by a telephone call. Our primary outcome was to assess the efficacy and tolerability of subcutaneous levetiracetam through the ictal frequency and adverse effects. Secondary outcomes were to assess the principal diagnosis, daily dose, duration of treatment, and outcomes of the patients.
Results: Twenty patients were identified. The age of subjects was between 26 and 96 years old, 13 were females. Only one patient had local effects adverse (edema and erythema). No severe adverse effects were documented, neither a rise in ictal frequency.
The main reason to switch to a subcutaneous route was severe dysphagia or encephalopathy in patients with palliative care. The principal diagnosis was structural focal epilepsy. Daily dose ranged from 1000 mg to 3000 mg and the duration of treatment was between 1 and 360 days. Twelve patients died during hospitalization and eight continued the treatment as outpatients.
Conclusions: In our experience subcutaneous levetiracetam seems to be well tolerated and effective in palliative care. It can be used when intravenous access or oral route are not possible or not recommended. Studies with a larger sample are needed.
Funding: Please list any funding that was received in support of this abstract.: Universidad del Rosario.
Case Studies