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Phenytoin and levetiracetam are equally effective second-line treatments for status epilepticus
  1. Rebecca Amy Dalrymple
  1. Department of General Paediatrics, Royal Hospital for Children Glasgow, Glasgow G83 0UA, UK
  1. Correspondence to Dr Rebecca Amy Dalrymple, Royal Hospital for Children, Glasgow, G51 4TF, UK; rebecca.dalrymple1{at}nhs.net

http://dx.doi.org/10.1136/archdischild-2019-318038

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    Review ofLyttle M, Rainford NEA, Gamble C, et al. Levetiracetam vs phenytoin for second-line treatment of paediatric convulsive status epilepticus (EcLiPSE): a multicentre, open-label, randomised trial. Lancet 2019;393:2125–34andDalziel SR, Borland ML, Furyk J, et al. Levetiracetam vs phenytoin for second-line treatment of convulsive status epilepticus in children (ConSEPT): an open-label, multicentre, randomised controlled trial. Lancet 2019;393:2135–45.

    ConSEPT trial: Levetiracetam is not superior to phenytoin in the management of convulsive status epilepticus

    Design: The 'Convulsive Status Epilepticus Paediatric Trial' (ConSEPT) was an open label randomised controlled trial.

    Allocation: 1:1 computer-generated block randomisation, stratified by site and age.

    Setting: 13 emergency departments (ED) in New Zealand and Australia (8 tertiary paediatric EDs).

    Patients: 234 children aged 3 months to 16 years presenting with convulsive status epilepticus. Patients had already received two doses of benzodiazepines.

    Intervention: Levetiracetam 40 mg/kg over 5 min intravenous or intraosseous.

    Comparison: Phenytoin 20 mg/kg over 20 min intravenous/intraosseous.

    The participant was assessed 5 min after the infusion had finished; if seizure activity was present, the other study medication was also given. A video was used to independently assess the time of seizure …

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    Footnotes

    • Twitter @becksDrD

    • Contributors RAD wrote the abstract and commentary.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; internally peer reviewed.