September 2017


Sign in or subscribe to listen

No me gusta!

The flash player was unable to start. If you have a flash blocker then try unblocking the flash content - it should be visible below.

Derek I., M.D. -

Great episode as always but I am concerned about some of the doses that you mentioned in your summary. As you alluded to, seizures have a kindling effect: they longer they go on, the more difficulty it is to stop the seizures. Specifically

The correct dose of levetiracetam is not 20 mg/kg but 60 mg/kg to maximum of 4500mg.

The correct dosing of valproic acid in status epilepticus is 40mg/kg to maximum dose of 3000mg.

There is a current multicenter trial examining the optimal 2nd line agent: Levetiracetam v. valproate v. fosphenytoin for status epilepticus

Would be happy to talk to you more about this subject as this is one of my interests.

Derek Isenberg, MD, FAAEM
Temple University

To join the conversation, you need to subscribe.

Sign up today for full access to all episodes and to join the conversation.