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Abstract Details

Pregabalin As Adjunctive Treatment For Symptomatic Cyclic Seizures In Neurocritically Ill Patients
Epilepsy/Clinical Neurophysiology (EEG)
P4 - Poster Session 4 (5:30 PM-6:30 PM)
12-004

To share our experience with Pregabalin (PGB) in neurocritically ill patients with refractory seizures
PGB is an approved adjunctive treatment for focal epilepsy in adults. PGB lacks drug-drug interactions, has a favorable safety profile and can be rapidly titrated. However, data remains limited regarding its use in the ICU setting.

Charts of eight patients admitted to UF Health Shands Neuroscience Intensive Care Unit from 1/2018  ?  3/2019 monitored on continuous electroencephalography (EEG) who received PGB  for the management of refractory seizure were reviewed retrospectively. Demographics, antiseizure drug (ASD) regimen, 24 hour EEG data pre and post PGB were analyzed descriptively.

The cohort comprised of eight patients (4 females) of which three patients had epilepsy, two with intracerebral hemorrhage (ICH), two with tumors, and one with cardiac arrest as underlying etiology of refractory seizures. All patients had other ASDs administered prior to PGB. Six of these patients received loading doses of ASDs prior to PGB. Loaded ASDs included Phenytoin (PHT), Levetiracetam (LEV), and Lacosamide (LCM). PGB was dosed 300-400mg/day in 2-4 divided doses, following a load of 75-300mg. PGB led to seizure cessation in 3 patients within 24h and in 2 additional patients within 48h of administration. PGB was successful in significantly (p<0.01 by paired Wilcoxon test) reducing average seizure burden 24 pre and post PGB administration from 8.08 minutes/hr to 3.10 minutes/hr.

In this critically ill cohort with refractory seizures, PGB successfully aborted seizures in 75% of patients. Average seizure burden was significantly lower after addition of PGB. PGB may represent a good alternative to other ASD in this population. Future studies should include prospective PGB treatment protocols.
Authors/Disclosures
Zachary M. Newcomer, DO
PRESENTER 		Dr. Newcomer has nothing to disclose.
Mitesh Patel, MD (University of Florida, Department of Neurology) Dr. Patel has nothing to disclose.
Katharina M. Busl, MD, MS, FÂ鶹´«Ã½Ó³»­ (University of Florida) Dr. Busl has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Rissman Law. Dr. Busl has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Huffman Powell Baley. Dr. Busl has received personal compensation in the range of $500-$4,999 for serving as a Consultant for University Science. Dr. Busl has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for SCCM. Dr. Busl has a non-compensated relationship as a Board Member with Art in Medicine that is relevant to Â鶹´«Ã½Ó³»­ interests or activities. Dr. Busl has a non-compensated relationship as a Associate Editor with Critical Care Explorations that is relevant to Â鶹´«Ã½Ó³»­ interests or activities. Dr. Busl has a non-compensated relationship as a Assistant Editor with Neurocritical Care that is relevant to Â鶹´«Ã½Ó³»­ interests or activities.
No disclosure on file
No disclosure on file
No disclosure on file
Marc Alain Babi, MD (Cleveland Clinic Foundation (Florida Region)) Dr. Babi has nothing to disclose.
Christopher P. Robinson, DO (University of Florida Department of Neurology) Dr. Robinson has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for law firms.
Maria J. Bruzzone, MD, FÂ鶹´«Ã½Ó³»­ (University of Florida) Dr. Bruzzone has nothing to disclose.
Maria Hella, MD (Baptist Health) Dr. Hella has nothing to disclose.
Stephan Eisenschenk, MD (Univ of Florida- Brain Institute) Dr. Eisenschenk has nothing to disclose.
Carolina B. Maciel, MD, MSCR, FÂ鶹´«Ã½Ó³»­ Dr. Maciel has received research support from American Heart Association. Dr. Maciel has received research support from National Institute of Health.