Abstracts

Rationale: Levetiracetam (LEV) is a new antiepileptic drug (AED), with a novel mechanism. The ability to use it in three forms (tablet, liquid and intravenous-IV- solution) will encourage the physicians to choose LEV in hospitalized epilepsy patients. The purpose of this study is to look at how often and circumstances under which physicians prefer LEV in hospitalized epilepsy patients and the efficacy of LEV. Methods: This is a retrospective study of use of IV LEV in 79 hospitalized epilepsy patients. The patients who received IV LEV were identified through the Cerner Power Vision System. The information regarding safety was obtained thorough central patient safety network at the tertiary medical center and discharge summaries. The following information was obtained; age, gender, history of epilepsy, use of any AED at home, the clinical presentation in ER, whether in status epilepticus or not, their response by reviewing the EEG reports, safety and condition upon discharge. Results: 79 patients who received IV LEV as inpatient were identified. 46 were male, 33 were female patients. The mean age for males was 55.3, for females was 54.9. There were no serious side effects reported for any of cases who received IV LEV. Patient seen in Emergency Room with recurrent seizures, or patients hospitalized with acute medical issues, IV route was the preferred route to administer LEV. There were 29 patients in status epilepticus. Status Epilepticus (SE) resolved in all cases except nine of them. The leading causes for SE in our cases were history of localization related epilepsy (LRE) (7), stroke (9), anoxic brain injury (7), and traumatic brain injury (3) and others (3). The order to receive IV LEV was the third be given in SE following lorazepam, phenytoin except few cases where LEV was the second agent to use. The leading causes of recurrent seizures in our patient population were history of LRE (18), stroke (14), CNS neoplasm (10) and hypoxic brain injury (5). 33 patients who received IV LEV due to recurrent seizures were discharged home on previous AEDs with addition of LEV or switched to LEV. 26 patients were on LEV at home prior to admission and 47 patients were discharged home on AEDs regimen including LEV. Conclusions: IV LEV is administered often in acute medical settings to treat recurrent seizures and status epilepticus. It is found to be safe to use and effective to control seizures in our inpatient population. The comparison of efficacy of LEV to other AEDs in SE is beyond the aim of the study but it can be considered as an area of interest for the future studies.