Efficacy of levetiracetam, fosphenytoin, and valproate for established status epilepticus by age group
RCT (n=462) concludes fosphenytoin, levetiracetam, or valproate can be considered a reasonable and appropriate first-choice, second-line drug in the treatment of both children and adults with established, benzodiazepine-refractory, status epilepticus.
Source:
The Lancet
SPS commentary:
The study evaluated use of either fosphenytoin, levetiracetam, or valproate in patients aged > 2years for a generalised convulsive seizure of longer than 5 min duration with adequate doses of benzodiazepines, and continued to have persistent or recurrent convulsions in the emergency department for at least 5 min and no more than 30 min after the last dose of benzodiazepine. The primary outcome of absence of clinically apparent seizures with improved consciousness and without additional antiseizure medication at 1 h from start of drug infusion was observed in 50% of patients in each of the 3 treatment groups.