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Phenytoin, Levetiracetam, and Pregabalin in the Acute Management of Refractory Status Epilepticus in Patients with Brain Tumors
Neurocritical Care , 09/06/2011
Clinical Article
Swisher CB et al. – The study suggests that the administration of phenytoin (PHT), levetiracetam (LEV), and pregabalin (PGB) in brain tumor patients with refractory status epilepticus (RSE) is safe and highly effective.
Methods- A retrospective chart review was performed on 23 patients with primary or metastatic brain tumors whose SE was treated with intravenous PHT, levetiracetam (LEV), and oral pregabalin (PGB).
- In all the patients under study, PHT or LEV was used as first–line therapy.
- PGB was typically used as third–line treatment.
- The median daily dose of PGB was 375 mg (usually divided BID or TID), and the median daily dose of LEV 3000 mg (usually divided BID).
- Cessation of SE was seen in 16/23 (70%) after administration of PHT, LEV, and PGB.
- SE was aborted, on average, 24 h after addition of the third antiepileptic drug.
- Only one patient in the responder group required intubation.
- Mortality rate was zero in the responder group.
- No adverse reactions to this medication regimen were observed.