Introduction: Neurologic emergencies such as status epilepticus (SE) and seizure cluster (SC) require urgent and consequent treatment with antiepileptic drugs (AEDs). Status epilepticus (SE) is the most severe manifestation of epilepsy, which requires intensive care. Aim: The purpose of this study was to evaluate the risk factors and clinical outcome of LCM in RSE patients in hospital setting. Material and methods: This retrospective analysis of patients with RSE was conducted on 52 patients of RSE who were admitted in the Emergency Medical Department or Neurology ward, of our tertiary care hospital (Postgraduate Institute of Medical Education and Research, Chandigarh). RSE was diagnosed if a first line (either lorazepam or diazepam) and a second line drug (either of the following: phenytoin or levetiracetam). Demographic information, history of epilepsy and precipitating causes, primary and secondary outcomes were also recorded and compared within the study groups. Results: When demographic profile of patients in two groups was compared, no significant difference was observed in parameters. Primary outcome of study was control of RSE within 30 minutes of start of infusion of the study drugs, which was seen in 16 (30.77%) patients. Various secondary outcomes were recurrence of SE within 24 hrs after control of seizures, need for ventilatory assistance, final neurological outcome at discharge as assessed by mRS and adverse drug reactions. Overall there were no differences in primary and secondary outcomes in the case and control groups. Thus, either of the drug combinations was equally effective in terms of all primary and secondary outcome measures. Conclusion: Although our observations are limited as its a retrospective design, and the short-term follow-up as well as the small cohort. Therefore further large studies and randomized control trials is needed to establish the therapeutic effect of IV LCM in treatment of RSE.
Key words: Lacosimide, Refractory Status Epilepticus.
Received: 24 February, 2019 Revised: 28 March, 2019 Accepted: 29 March, 2019
Corresponding author: Dr. Amit Sharma, Senior Resident, Department of Neurology, Post Graduate Institute of Medical Education & Research, Chandigarh, India
This article may be cited as: Sharma A, Singh P, Goyal MK, Lal V. Risk Factors and Clinical Outcome Status Of Patients with Refractory Status Epilepticus undergoing Treatment with Lacosimide. J Adv Med Dent Scie Res 2019;7(5): 14-20.