Termination of complex partial status epilepticus by intravenous levetiracetam

Abstract

We report the case of complex partial status epilepticus refractory to intravenous loading with phenytoin which responded to administration to the newly released intravenous formula of levetiracetam. A 29-year-old female patient with pharmacoresistant focal epilepsy developed complex partial status epilepticus during video-EEG-monitoring following withdrawal of antiepileptic drugs. Status developed after a series of generalized tonic clonic seizures despite intravenous loading with phenytoin and consisted of repeated brief tonic and automotor complex partial seizures with persistent impairment in cognitive speed, ability to perform verbal tasks, and orientation. Intravenous administration of 1000 mg levetiracetam over a period of 15 minutes resulted in a reduction of ictal EEG discharges and disappearance of clinical symptomatology within 35 minutes after initiation of treatment. This suggests that intravenous levetiracetam may be a potent agent also for complex partial status epilepticus.