Levetiracetam, Lacosamide and Ketamine as Adjunctive Treatment of Refractory Status Epilepticus
Epilepsy, Status Epilepticus
About this trial
This is an interventional treatment trial for Epilepsy focused on measuring refractory status epilepticus, levetiracetam, lacosamide, ketamine
Eligibility Criteria
Inclusion Criteria:
- Age 18-70
- Ability and willingness by surrogates to signed informed consent form.
- Clinically and electrographically documented ongoing SE lasting ≥1 hour- ≤24 hours
Exclusion Criteria:
- Creatinine > 2.5 mg/dl
- Any systemic illness or unstable medical condition that might pose additional risk, including: cardiac, metabolic or endocrine disturbances, renal or liver disease
- Active drug or alcohol dependence or any other factors that, in the opinion of the site investigators would interfere with adherence to study requirements
- Pregnancy
- Inability or unwillingness of subject or legal surrogate to give written informed consent
- Known allergy to a study drug
- Hypo- or hyperglycemia as cause of SE
Sites / Locations
- MidAtlantic Epilepsy and Sleep Center
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Active Comparator
Active Comparator
Active Comparator
Active Comparator
levetiracetam
lacosamide
ketamine
phenobarbital
Patients with status epilepticus who have been treated with standard dose lorazepam (or midazolam) and ≥ 1000 mg phenytoin with documented levels of ≥20 mg/ml and continue to have clinical SE for ≥1-24 hours after phenytoin loading will receive intravenously (i.v.) 4000 mg levetiracetam.
Patients with status epilepticus who have been treated with standard dose lorazepam (or midazolam) and ≥ 1000 mg phenytoin with documented levels of ≥20 mg/ml and continue to have clinical SE for ≥1-24 hours after phenytoin loading will receive intravenously (i.v.) 600 mg lacosamide.
Patients with status epilepticus who have been treated with standard dose lorazepam (or midazolam) and ≥ 1000 mg phenytoin with documented levels of ≥20 mg/ml and continue to have clinical SE for ≥1-24 hours after phenytoin loading will receive intravenously (i.v.) 2.5 mg/kg ketamine.
Patients with status epilepticus who have been treated with standard dose lorazepam (or midazolam) and ≥ 1000 mg phenytoin (PHT) with documented levels of ≥20 mg/ml and continue to have clinical SE for ≥1-24 hours after PHT loading will receive intravenously (i.v.) phenobarbital 15 mg/kg.