Table 1.

Patient clinical characteristics, effect of levetiracetam, and loading and serum levels of levetiracetam

Pt	Age (yrs)	Medical History	Presentation	Load Dose (mg/kg)	Serum Level (μg/mL)	Effect	Short-Term Outcome
1	14	Cardiac transplantation on immunosuppressant medication. Renal and liver dysfunction. Hypotension requiring vasopressors. Intubated. Comatose	Generalized convulsion followed by multifocal malignant NCSE refractory to phenobarbital (level 52) and phenytoin (level 14)	13	16	Temporary termination of sz. No adverse effects	Care withdrawn. Fungal sepsis and meningitis
2	9	Previously healthy. Presumed encephalitis of unknown etiology. Intubated. Comatose	Single seizure followed by malignant NCSE refractory to phenytoin (level 24) and phenobarbital (level 51)	26	19	Temporary termination of sz. No adverse effects	Care withdrawn
3	2	Previously healthy. Presumed encephalitis of unknown etiology. Intubated. Comatose	Malignant NCSE refractory to phenytoin (level 22)	20	26	Temporary termination of sz. No adverse effects	Developed progressive cerebral edema. Care withdrawn
4	5	Previously healthy. Cardiac arrest due to anaphylaxis treated with therapeutic hypothermia protocol. Hypotension requiring vasopressors. Intubated. Comatose	NCSE during rewarming period. LEV used as first-line anticonvulsant	20	8	Termination of NCSE. No adverse effect	Moderate neuropsychological impairment (able to talk and ambulate)
5	13	Previously healthy. Cardiac arrest treated of unknown etiology treated with therapeutic hypothermia protocol. Hypotension requiring vasopressors. Intubated Comatose	NCSE during rewarming period. LEV used as first-line anticonvulsant	22	8	Termination of NCSE. No adverse effects	Moderate neuropsychological impairment (able to talk and ambulate)
6	5	DiGeorge syndrome with truncus arteriosus repair at birth admitted for truncal aortic valve replacement. Intubated. Obtunded	Postoperative 4 clinical repetitive focal seizures with secondary generalization LEV used as first-line anticonvulsant	21	32	No sz occurred after LEV. No adverse effects	Unknown
7	0.08	Nonaccidental traumatic brain injury with subdural hematoma status postevacuation and parenchymal hemorrhage. Lethargic	Persistently altered mental status. Frequent subclinical focal seizures. LEV used as first-line anticonvulsant	31	37	No sz occurred after LEV. No adverse effects	Severe neurologic impairment
8	0.25	Desmoplastic infantile ganglioglioma resection. Lethargic	Postoperative 4 clinical focal seizures. LEV used as first-line anticonvulsant	30	40	No sz occurred after LEV. No adverse effects	Normal infant
9	4	Previously healthy. Asystolic cardiac arrest of unclear etiology. Intubated. Comatose	Persistently altered mental status. Frequent subclinical focal seizures. LEV used as first-line anticonvulsant	30	41	LEV reduced sz by 75%. Another 30 mg/kg intravenous loaded 1.5 hrs later and seizures terminated. No adverse effects	Severe neurologic impairment
10	7	Previously healthy. Enterovirus encephalitis. Obtunded	Persistently altered mental status and abnormal eye blinks associated with Bi-PEDS and burst suppression. LEV employed as first line anticonvulsant	15	27	Reduction of Bi-PEDS by 75%. No adverse effect	Moderate neuropsychological impairment (able to talk and ambulate)

LEV, levetiracetam; NCSE, nonconvulsive status epilepticus; PED, periodic epileptiform discharges; sz, seizure.

“Temporary termination of sz” = 12–24 hrs.