Role of intravenous levetiracetam in acute seizure management of children.

Status epilepticus is defined as a seizure lasting beyond 30 minutes. Children with intractable epilepsy undergo frequent hospital admissions secondary to status epilepticus or because of acute exacerbation of seizures. Intravenous levetiracetam became available in August 2006 for use in patients aged above 16 years. There are insufficient data about the efficacy and safety of intravenous levetiracetam in children. We retrospectively analyzed data from children treated with intravenous levetiracetam for status epilepticus and acute exacerbation of seizures. We acquired data from our institution's electronic medical records concerning patients with status epilepticus and acute exacerbation of seizures who received intravenous levetiracetam. Thirty-two patients (age range, 2 months to 18 years) had received a levetiracetam load of 25-50 mg/kg for status epilepticus. There were 17 (53.1%) males and 15 (46.8%) females. Response to intravenous levetiracetam in all patients was favorable. Status epilepticus ceased clinically and electrographically. Eighteen patients (56.5%) received intravenous levetiracetam after receiving fosphenytoin and Ativan with no response. No serious side effects were evident. Fifteen patients (46.8%) were discharged on levetiracetam monotherapy, and 9 (28.1%) received levetiracetam as adjunctive therapy after discharge from the hospital. Intravenous levetiracetam can be used adjunctively or as monotherapy in children with status epilepticus and acute exacerbation of seizures.