There is no evidence for superiority in the efficacy or safety of immunoglobulin or plasmapheresis in the management of Guillain-Barré syndrome and myasthenia gravis. However, caution should be exercised in the interpretation of these results given the limitations in the quality of the evidence and the heterogeneity of the studies.
Background: Seizures are common in palliative care. Their control is essential in the management of these patients as it helps to reduce suffering at the end of life. Subcutaneous levetiracetam has been used off-license for seizure control in palliative care.
Aim: Describe the experience of subcutaneous levetiracetam in two hospitals in Bogota, Colombia
Methods: We conducted a retrospective review of patients treated with subcutaneous levetiracetam in two hospitals in Colombia during 2019–2021.Data were extracted from medical records, and participants were followed up as outpatients.
Results: Twenty-one patients were identified. No severe adverse effects or a rise in ictal frequency were documented. Twelve patients died during hospitalization and nine continued treatment as outpatients. The principal diagnosis was structural focal epilepsy. The daily dose ranged from 1000 mg to 3000 mg, and the duration of treatment varied amongst subjects between 1 and up to 360 days.
Conclusion: In our experience, subcutaneous levetiracetam was well-tolerated and effective in controlling seizures in palliative care when oral administration or intravenous access was not an option. Randomized controlled trials are needed to elucidate the efficacy and tolerability of subcutaneous levetiracetam in clinical practice.
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