Use of oxcarbazepine for treatment of refractory status epilepticus

PURPOSE Oxcarbazepine (OXC) is an effective anticonvulsant used for treatment of partial and secondarily generalized seizures. However, there is almost no data regarding its effectiveness and tolerability when used for treatment of status epilepticus (SE). METHODS We retrospectively identified all patients who received OXC for treatment of SE in our hospital between July 2008 and December 2010 in our hospital and analyzed all available data. RESULTS We identified 13 patients (median age 79 years) who were treated with OXC for refractory SE after failure of first- and second-line therapy in our institution. In the majority of patients, etiology was remote symptomatic (10/13), and semiology was nonconvulsive (10/13). OXC was initiated as third or later agent in almost all patients after median latency of 81 h with a median maximum daily dose of 1800 mg. OXC was the last drug before SE cessation in 8/13 patients. Relevant hyponatriemia <125 mmol/l was seen in 3 patients. CONCLUSION OXC may be an effective alternative in refractory SE, but patients need to be monitored closely for hyponatriemia. PRACTICE IMPLICATIONS OXC could be used for refractory SE under close electrolyte monitoring when standard agents fail or are unsuitable.