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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

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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 cessation.

Primary outcomes: Clinical cessation of seizure activity 5 min after infusion completion.

Secondary outcomes: Clinical cessation of seizures 2 hours after infusion of 1 or 2 drugs, need for rapid sequence induction, time to seizure cessation, intensive care unit admission, serious adverse events, seizure status …

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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.

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