Abstract
Status epilepticus (SE) is a major clinical emergency that is associated with high mortality and morbidity. SE causes significant neuronal injury and survivors are at a greater risk of developing acquired epilepsy and other neurological morbidities, including depression and cognitive deficits. Benzodiazepines and some anticonvulsant agents are drugs of choice for initial SE management. Despite their effectiveness, over 40% of SE cases are refractory to the initial treatment with two or more medications. Thus, there is an unmet need of developing newer anti-SE drugs. Levetiracetam (LEV) is a widely prescribed anti-epileptic drug that has been reported to be used in SE cases, especially in benzodiazepine-resistant SE or where phenytoin cannot be used due to allergic side-effects. Levetiracetam’s non-classical anti-epileptic mechanisms of action, favorable pharmacokinetic profile, general lack of central depressant effects, and lower incidence of drug interactions contribute to its use in SE management. This review will focus on LEV’s unique mechanism of action that makes it a viable candidate for SE treatment.
Highlights
STATUS EPILEPTICUS: DEFINITION, CAUSES AND CONSEQUENCES Status epilepticus (SE) is a neurological emergency associated with a significant morbidity and mortality [1]
CONCLUDING REMARKS Levetiracetam is a unique anticonvulsant agent that has multiple mechanism of action that differentiates it from conventional anticonvulsant drugs
This makes it an ideal agent to add to the treatments for SE
Summary
STATUS EPILEPTICUS: DEFINITION, CAUSES AND CONSEQUENCES Status epilepticus (SE) is a neurological emergency associated with a significant morbidity and mortality [1]. Epidemiological studies have shown that time to seizure treatment varies broadly with only about 41% of all patients receiving their first anti-epileptic drug within 30 min [16]. The rest of this article will mainly focus on the molecular targets and unique mechanism of actions of LEV that makes it such an attractive drug candidate for the treatment of SE, and other neurological disorders such as Huntington’s chorea [29], Tardive dyskinesia [30], Tourette syndrome [31], anxiety disorders [32], traumatic brain injury and stroke [33], amongst others.
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