Background: Seizures are common in palliative care. Their control is essential in the management of these patients as it helps to reduce suffering at the end of life. Subcutaneous levetiracetam has been used off-license for seizure control in palliative care. Aim: Describe the experience of subcutaneous levetiracetam in two hospitals in Bogota, Colombia Methods: We conducted a retrospective review of patients treated with subcutaneous levetiracetam in two hospitals in Colombia during 2019–2021.Data were extracted from medical records, and participants were followed up as outpatients. Results: Twenty-one patients were identified. No severe adverse effects or a rise in ictal frequency were documented. Twelve patients died during hospitalization and nine continued treatment as outpatients. The principal diagnosis was structural focal epilepsy. The daily dose ranged from 1000 mg to 3000 mg, and the duration of treatment varied amongst subjects between 1 and up to 360 days. Conclusion: In our experience, subcutaneous levetiracetam was well-tolerated and effective in controlling seizures in palliative care when oral administration or intravenous access was not an option. Randomized controlled trials are needed to elucidate the efficacy and tolerability of subcutaneous levetiracetam in clinical practice.


中文翻译：

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左乙拉西坦皮下注射在姑息治疗中的应用体会

背景：癫痫发作在姑息治疗中很常见。他们的控制对于这些患者的管理至关重要，因为它有助于减少临终时的痛苦。皮下注射左乙拉西坦已被非法用于姑息治疗中的癫痫发作控制。目的：描述哥伦比亚波哥大两家医院皮下注射左乙拉西坦的经验方法：我们对 2019-2021 年哥伦比亚两家医院皮下注射左乙拉西坦治疗的患者进行回顾性评价。数据从病历中提取，并对参与者进行随访作为门诊病人。结果：确定了 21 名患者。没有记录到严重的不良反应或发作频率的增加。十二名患者在住院期间死亡，九名患者继续在门诊接受治疗。主要诊断为结构性局灶性癫痫。每日剂量范围为 1000 毫克至 3000 毫克，治疗持续时间因受试者而异，从 1 天到 360 天不等。结论：根据我们的经验，当无法选择口服给药或静脉注射时，皮下注射左乙拉西坦在姑息治疗中具有良好的耐受性和有效控制癫痫发作的效果。需要随机对照试验来阐明皮下注射左乙拉西坦在临床实践中的疗效和耐受性。