Effectiveness of Non-benzodiazepine Antiepileptic Drugs in Benzodiazepine-resistant ‎Convulsive Status Epilepticus

Abstract

Background: Time-dependent pharmacoresistance is a major therapeutic problem in SE and CSE. As seizures continue, pharmacoresistance develops progressively. The anti-seizure effectiveness of benzodiazepines could reduce 20-fold in 30 min of seizures. The objective of this study is to précis the existing proof that compares the effect of valproate, phenytoin, diazepam, phenobarbital, lacosamide, and levetiracetam on benzodiazepineresistant convulsive status epilepticus. Method: This systematic review was conducted, including PubMed, Google Scholar, and EBSCO that examining randomized trials of non-benzodiazepine antiepileptic drugs in benzodiazepine-resistant convulsive status epilepticus. Authors extracted the data, and then the author's names, year and region of publication, the study type, period of study, and the result were reported. Results: The review included 9 randomized studies that compared non-benzodiazepine antiepileptic drugs in terms of efficacy and adverse effects for SE management. Conclusion: Valproate, phenytoin, diazepam, phenobarbital, lacosamide, and levetiracetam are all conventional agents that could be given as second-line management of status epilepticus and in cases of benzodiazepineresistant convulsive status epilepticus. Though, the use of these medications is restricted due to their toxicity.

Investigation of Correlation between Resistance to Diazepam and Expression of Inflammatory Markers in The Peripheral Blood of Patients with Status of Epilepticus

“…Time-dependent pharmacoresistance Clinical Medicine is a major issue in SE. The anticonvulsant efficacy of BZD may decrease up to 20-fold after 30 minutes of seizure activity (11)(12)(13). In addition, 30 minutes of convulsive SE may also indicate irreversible brain damage, as shown experimentally (14).…”