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Case report
Intravenous brivaracetam for the management of refractory focal non-convulsive status epilepticus
  1. Abdalla A Ammar1,
  2. Mahmoud A Ammar1,
  3. Kent Owusu1,2 and
  4. Emily J Gilmore3
  1. 1Department of Pharmacy, Yale New Haven Health System, New Haven, Connecticut, USA
  2. 2Clinical Redesign, Yale New Haven Health System, New Haven, Connecticut, USA
  3. 3Department of Neurology, Division of Neurocritical Care and Emergency Neurology, Division of Epilepsy, Yale New Haven Health System, New Haven, Connecticut, USA
  1. Correspondence to Dr Abdalla A Ammar; abdalla.ammar{at}ynhh.org

Abstract

Diagnosis and management of status epilepticus (SE), including non-convulsive status epilepticus (NCSE), is challenging, with a reported 30%–50% of epilepticus patients not responding to available antiseizure medications (ASMs). Injectable benzodiazepines, fosphenytoin, valproate, levetiracetam, lacosamide and phenobarbital are commonly used for treating SE. Brivaracetam, a new ASM, with higher affinity and greater selectivity for the synaptic vesicle glycoprotein 2A than levetiracetam, has been approved as monotherapy or adjunct for treatment of focal onset seizures. Brivaracetam may have a role in the management of SE. However, limited data exist on brivaracetam’s efficacy in SE. We describe a patient case with focal NCSE refractory to levetiracetam, fosphenytoin, lacosamide and valproate who demonstrated clinical and electrographic improvement on continuous electroencephalography monitoring after brivaracetam administration.

  • neurology (drugs and medicines)
  • epilepsy and seizures
  • pharmacology and therapeutics

https://doi.org/10.1136/bcr-2020-234955

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    Footnotes

    • Twitter @AbdallaTweet

    • Contributors EJG and AAA were part of the medical care during the admittance of the patient. AAA, MAA, KO and EJG wrote the final manuscript, approved the final version of the article and equally contributed to the article.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Next of kin consent obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.