Lidocaine for status epilepticus in adults

Abstract Introduction Our goal was to perform a systematic review of the literature on the use of intravenous lidocaine in adults for status epilepticus (SE) and refractory status epilepticus (RSE) to determine its impact on seizure control. Methods All articles from MEDLINE, BIOSIS, EMBASE, Global...

Full description

Saved in:
Bibliographic Details
Published in:Seizure (London, England) England), 2015-09, Vol.31, p.41-48
Main Authors: Zeiler, F.A, Zeiler, K.J, Kazina, C.J, Teitelbaum, J, Gillman, L.M, West, M
Format: Article
Language:English
Subjects:
Adult
Anticonvulsants - adverse effects
Anticonvulsants - therapeutic use
Humans
Lidocaine
Lidocaine - adverse effects
Lidocaine - therapeutic use
Neurology
Refractory
Seizures - drug therapy
Seizures - physiopathology
Status epilepticus
Status Epilepticus - drug therapy
Status Epilepticus - physiopathology
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Introduction Our goal was to perform a systematic review of the literature on the use of intravenous lidocaine in adults for status epilepticus (SE) and refractory status epilepticus (RSE) to determine its impact on seizure control. Methods All articles from MEDLINE, BIOSIS, EMBASE, Global Health, HealthStar, Scopus, Cochrane Library, the International Clinical Trials Registry Platform (inception to November 2014), and gray literature were searched. The strength of evidence was adjudicated using both the Oxford and GRADE methodology by two independent reviewers. Results Overall, 13 studies were identified, with 11 manuscripts and 2 meeting abstracts. Seventy-six adult patients were treated for 82 episodes of SE/RSE. Patients had varying numbers of anti-epileptic drugs (AEDs), 1–12, on board prior to lidocaine therapy. During 69 of the 82 (84.1%) episodes of SE/RSE, phenytoin was on board. The dose regimen of lidocaine varied, with some utilizing bolus dosing alone; others utilizing a combination of bolus and infusion therapy. Overall, 70.7% of seizures responded to lidocaine, with complete cessation and greater than 50% reduction seen in 64.1% and 6.1% respectively. Patient outcomes were sparingly reported. Conclusions There currently exists level 4, GRADE C evidence to support the consideration of lidocaine for SE and RSE in the adult population. Thus there is currently weak evidence to support the use of lidocaine in this context. Further prospective studies of lidocaine administration in this setting are warranted.
ISSN:1059-1311
1532-2688
DOI:10.1016/j.seizure.2015.07.003