Use of pregabalin for nonconvulsive seizures and nonconvulsive status epilepticus

Swisher, Christa B.; Doreswamy, Meghana; Husain, Aatif M.

doi:10.1016/j.seizure.2012.11.004

Cited by 16 publications

(8 citation statements)

References 15 publications

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“…Swisher and co-workers reported a success rate of 52% for pregabalin. 2 However, they included patients with acute repetitive seizures as well as patients with post-hypoxic SE, and pregabaline was initiated as second to fourth agent. Therefore, comparison is difficult.…”

Section: Discussionmentioning

confidence: 99%

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Use of oxcarbazepine for treatment of refractory status epilepticus

Kellinghaus

Berning

Stögbauer

2014

Seizure

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Section: Discussionmentioning

confidence: 99%

“…If this approach fails, one of the rescue strategies is to introduce one of the oral anticonvulsants by nasogastric tube. Topiramate (TPM) 1,2 and pregabalin (PGB) 3,4 have been used in this situation with some degree of success.…”

Section: Introductionmentioning

confidence: 99%

Use of oxcarbazepine for treatment of refractory status epilepticus

Kellinghaus

Berning

Stögbauer

2014

Seizure

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“…A retrospective study reported definite electroclincal response at 24 h in 5 of 11 patients after PGB 450 mg, and a possible response in 3 . Analysis of 21 patients with nonconvulsive repetitive seizures or SE described a 52% responder rate; this proved much higher in repetitive seizures (82%) than in SE (18%) (Swisher et al 2013).…”

Section: Pregabalin (Pgb)mentioning

confidence: 93%

Anticonvulsive Drug Use in Status Therapy: Adults

Beuchat¹,

Rossetti²

2020

NeuroPsychopharmacotherapy

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In adults, status epilepticus represents after stroke one of the most frequent neurological emergencies. Depending on the type and duration of seizures, it can induce considerable morbidity and mortality, therefore requiring immediate management. International guidelines recommend a stepwise approach, where treatment lines are used sequentially and additionally. In early status epilepticus, benzodiazepines represent the first line of treatment, typically followed by intravenous antiepileptic drugs in established status epilepticus. If seizures continue after this stage, the situation is labelled as refractory status epilepticus; intravenous anesthetics with coma induction (third line treatment) are advocated, particularly in patients not protecting their airways and showing generalizedconvulsive or nonconvulsive status epilepticus in coma. Additional treatment lines, such as ketogenic diet, ketamine, corticosteroids, may be prescribed in super-refractory status epilepticus, a condition resulting for treatment resistance to at least one trial of general anesthetics. Besides the first-line treatment, evidence regarding medications commonly used in status epilepticus is quite limited, especially in later stages. In this chapter, we describe pharmacological compounds according to this stepwise approach, considering existing evidence, advantages, and drawbacks of each molecule.

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“…As second-line therapy (if convulsions persist), valproic acid and levetiracetam are often recommended (1,2). Pregabalin is rarely used for status epilepticus but has been used as add-on treatment and for non-convulsive status epilepticus (35,36). Judging from the present obervations in rats, levetiracetam may be the best choice for drugresistant seizures because gain of consciousness was obtained in most rats with levetiracetam.…”

Section: Effects Of Anticonvulsant Treatment On Cholinergic Activationmentioning

confidence: 99%

Effects of Three Anti-Seizure Drugs on Cholinergic and Metabolic Activity in Experimental Status Epilepticus

et al. 2019

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Purpose. Status epilepticus (SE) is characterized by recurrent seizure activity and can be drug-resistant. Knowledge of neuronal and metabolic activity of the brain during SE may be helpful to improve medical care. We here report the effects of three anti-seizure drugs on changes of acetylcholine energy metabolites and oxidative stress during SE. Methods. We used the lithium-pilocarpine model in rats to induce SE and in vivo-microdialysis to monitor cholinergic and metabolic activity in the hippocampus. We measured extracellular concentrations of acetylcholine, glucose, lactate, pyruvate, glycerol and isoprostanes before and during SE, and after acute treatment with pregabalin, valproic acid, and levetiracteam. Results. Upon onset of SE, acetylcholine (ACh) release increased six- to eightfold. Glucose was increased only transiently by 30% but lactate levels rose four-fold, and extracellular concentrations of glycerol ten-fold. Isoprostanes are markers of oxidative stress and increased more than 20-fold. Two hours after pilocarpine adminstration, rats were treated with pregabalin (100 mg/kg), levetiracetam (200 mg/kg) or valproic acid (400 mg/kg) by i.p. injection. All three drugs stopped seizure activity in a delayed fashion, but at the doses indicated, only animals that received levetiracetam reached consciousness. All drugs reduced ACh release within 60-120 minutes. Lactate/pyruvate ratios, glycerol and isoprostanne levels were also reduced significantly after drug administration. Conclusions. Hippocampal ACh release closely follows seizure activity in SE and is attenuated when SE subsides. Pregabalin, valproic acid and levetiracetam all terminate seizures in the rat SE model and attenuate cholinergic and metabolic changes within two hours.

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Use of pregabalin for nonconvulsive seizures and nonconvulsive status epilepticus

Abstract: Pregabalin may be safe option for add-on treatment for nonconvulsive seizures in critically ill patients when conventional therapy fails.

Cited by 16 publications

References 15 publications

Use of oxcarbazepine for treatment of refractory status epilepticus

Use of oxcarbazepine for treatment of refractory status epilepticus

Anticonvulsive Drug Use in Status Therapy: Adults

Effects of Three Anti-Seizure Drugs on Cholinergic and Metabolic Activity in Experimental Status Epilepticus

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