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Complex partial status epilepticus is a non-convulsive state of persistent behavioural change from baseline functioning, with continuous or intermittent ictal epileptic EEG discharges.1–3 Although relatively common, it is often difficult to diagnose. Treatment with widely available antiepileptic drugs is of limited success and can have relevant side effects.1 4 Here we report the use of a newly released intravenous formula of levetiracetam in a patient who, despite intravenous loading with phenytoin and oral administration of lorazepam, developed complex partial status epilepticus following a series of generalised tonic–clonic seizures. Video EEG monitoring showed resolution of mental clouding and a reduction in ictal EEG patterns within 35 min of administration of levetiracetam.
This 29-year-old female patient suffered from cryptogenic focal epilepsy since the age of 11 years. No typical risk factors for the development of epilepsy were present. In particular, there was no evidence of birth related injury, or neonatal or febrile convulsions. Her psychosocial, motor and cognitive development was normal until the onset of epilepsy and concomitant mental retardation. Seizures had been refractory to treatment with primidone, phenytoin, phenytouride, sultiam, topiramate, carbamazepine, oxcarbazepine, lamotrigine, zonisamide, pregabalin and valproate. Seizure types were complex partial seizures as well as tonic and generalised tonic–clonic seizures. Earlier oral treatment with valproic acid resulted …
Competing interests: None.