Abstracts

Rationale: Use of levetiracetam (LEV) in Japan has been expanding especially in neurosurgical field since its approval in 2010 because of the efficacy, convenience of prescription, and less adverse reactions. Furthermore, LEV is now recognized as the first line in monotherapy for partial onset seizures. Then intravenous LEV was ultimately approved in 2015. Our early experience regarding intravenous LEV is reported here. Methods: Patients treated by intravenous LEV were retrospectively evaluated. Patients' diseases, doses of intravenous LEV, efficacy, adverse reactions, and consequences were particularly investigated. Results: Twenty-one patients including 12 females and 9 males were treated by intravenous LEV. Age of patients ranged from 11 through 88 years old, and the mean age was 43 years old. Fourteen patients (67%) among them had been treated for their epilepsies. Diagnoses were symptomatic localization-related epilepsies such as temporal lobe epilepsies (33%), brain tumors (19%), cerebrovascular diseases (19%), and head injuries (9%). Most of them were treated at the Neurosurgical Service, the Comprehensive Epilepsy Center, and the Stroke Care Center in our hospital. Doses of intravenous LEV per day were 500mg twice a day (47%), 500mg once a day (19%), and 1,000mg once a day (19%). These were used only for 1 to 2 days when patients could not take orally. Intravenous LEV was given in pre and post-operative periods in 10%, post-operative periods in 38%, and for non-surgical patients in 52%. In terms of consequences following intravenous LEV, 7 patients (33%) restarted oral LEV because they took LEV before surgery or these acute stages of the diseases, and 12 patients (57%) switched over from intravenous to oral LEV as the first time. Conclusions: Intravenous LEV was given to patients in neurological emergency and neurosurgical perioperative periods. Although intravenous LEV was used only 1 to 2 days, it was convenient to use and seizure control was well done. Switching over to oral LEV was also simple. Therefore intravenous LEV is a very useful drug when patients cannot take medications orally. Funding: Not applicable