Levetiracetam in der Behandlung des Status epilepticus – ein update

 

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Zusammenfassung

Seit 2004 liegen Publikationen zum Einsatz von Levetiracetam beim Status epilepticus vor. In der vorliegenden Arbeit werden basierend auf einer PubMed-Literatur-Recherche vom 06.07.2018 die nach dem 12.12.2011 erschienenen Arbeiten zusammenfassend dargestellt und in der Diskussion mit den älteren Arbeiten verglichen. Es wurden 28 Behandlungsepisoden in Berichten über 1-2 Fälle und 412 Behandlungsepisoden in Fallserien und prospektiven Studien beschrieben. Dabei ließ sich aus den Fallserien und Studien ein hochwahrscheinlicher Mittelwert der Erfolgsrate für die Status-Durchbrechung von 55,0 %-59,4 % ableiten. Auf-grund des zu vermutenden verzögerten Wirkungseitritts des Levetiracetams ist sein Einsatz beim Status generalisierter tonisch-klonischer Anfälle dennoch zu hinterfragen. Als Loading-Dosis erscheinen 30 mg / kg KG angemessen

Abstract

Since 2004 several reports on the treatment of status epilepticus with levetiracetam have been published. In this review, the results of a PubMed-based search of publications December 12, 2011 - July 6, 2018 are summarized and compared to those of earlier publications. In total, 28 treatment episodes in case reports, each on one or two cases of treatment episodes, and 412 treatment episodes in case series and prospective studies were analyzed. Case series and prospective studies reported an average success rate for termination of status probably of 55,0 %-59,4 %. Since preclinical data suggest a delayed effect of levetiracetam, its use in the treatment of generalized convulsive status epilepticus appears still questionable. A loading dose of 30 mg / kg seems to be reasonable.

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