Levetiracetam versus phenytoin in children with status epilepticus

Background: To compare the efficacy and safety of intravenous levetiracetam and phenytoin in status epilepticus. Methodology: A prospective, randomized controlled, nonblinded study was conducted in children 1 month to 12 years of age with active seizure and with status epilepticus. A total of 104 ch...

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Main Authors: Gowhar Wani, Ayesha Imran, Neeraj Dhawan, Anumodhan Gupta, Javed I Giri
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2019-01-01
Series:Journal of Family Medicine and Primary Care
Subjects:
Online Access:http://www.jfmpc.com/article.asp?issn=2249-4863;year=2019;volume=8;issue=10;spage=3367;epage=3371;aulast=Wani
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author Gowhar Wani
Ayesha Imran
Neeraj Dhawan
Anumodhan Gupta
Javed I Giri
author_facet Gowhar Wani
Ayesha Imran
Neeraj Dhawan
Anumodhan Gupta
Javed I Giri
author_sort Gowhar Wani
collection DOAJ
description Background: To compare the efficacy and safety of intravenous levetiracetam and phenytoin in status epilepticus. Methodology: A prospective, randomized controlled, nonblinded study was conducted in children 1 month to 12 years of age with active seizure and with status epilepticus. A total of 104 children were randomly allocated to either group 1 (levetiracetam) or group 2 (phenytoin) on the basis of computer-generated random number table. Children already on antiepileptic drugs, very sick children with shock, impending respiratory failure, or head injury, and children hypersensitive to phenytoin or levetiracetam were excluded. Data analysis was done by IBM SPSS statistics. Results: The mean age was 4.09 years with a male preponderance with the most common type of seizure being generalized type (74%). The seizures were controlled in all 104 patients initially within 40 min. Seizure control for 24 h was significantly better in group 1 (96%) when compared with group 2 (59.6%) (P = 0.0001). Minibolus of drug was given in 28.8% in group 1 and 46.2% in group 2 (P = 0.068).The seizure recurrence in groups 1 and 2 in the first hour was 1.9% and 5.8%, respectively (P = 0.61), whereas the recurrence between 1 and 24 h was significantly more in group 1 (34.6%) when compared with group 2 (3.8%) (P = 0.0001). The mean time to control seizure was comparable between both the groups (P = 0.71). There was no significant adverse effect in both the groups. Conclusion: Levetiracetam is more effective than phenytoin for seizure control for 24 h in children with status epilepticus, and it is safe and effective as a second-line therapy.
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spelling doaj.art-ac1c87b52c6c49209b40a27c92c7ffed2022-12-22T01:08:10ZengWolters Kluwer Medknow PublicationsJournal of Family Medicine and Primary Care2249-48632019-01-018103367337110.4103/jfmpc.jfmpc_750_19Levetiracetam versus phenytoin in children with status epilepticusGowhar WaniAyesha ImranNeeraj DhawanAnumodhan GuptaJaved I GiriBackground: To compare the efficacy and safety of intravenous levetiracetam and phenytoin in status epilepticus. Methodology: A prospective, randomized controlled, nonblinded study was conducted in children 1 month to 12 years of age with active seizure and with status epilepticus. A total of 104 children were randomly allocated to either group 1 (levetiracetam) or group 2 (phenytoin) on the basis of computer-generated random number table. Children already on antiepileptic drugs, very sick children with shock, impending respiratory failure, or head injury, and children hypersensitive to phenytoin or levetiracetam were excluded. Data analysis was done by IBM SPSS statistics. Results: The mean age was 4.09 years with a male preponderance with the most common type of seizure being generalized type (74%). The seizures were controlled in all 104 patients initially within 40 min. Seizure control for 24 h was significantly better in group 1 (96%) when compared with group 2 (59.6%) (P = 0.0001). Minibolus of drug was given in 28.8% in group 1 and 46.2% in group 2 (P = 0.068).The seizure recurrence in groups 1 and 2 in the first hour was 1.9% and 5.8%, respectively (P = 0.61), whereas the recurrence between 1 and 24 h was significantly more in group 1 (34.6%) when compared with group 2 (3.8%) (P = 0.0001). The mean time to control seizure was comparable between both the groups (P = 0.71). There was no significant adverse effect in both the groups. Conclusion: Levetiracetam is more effective than phenytoin for seizure control for 24 h in children with status epilepticus, and it is safe and effective as a second-line therapy.http://www.jfmpc.com/article.asp?issn=2249-4863;year=2019;volume=8;issue=10;spage=3367;epage=3371;aulast=Waniefficacylevetiracetamphenytoinstatus epilepticus
spellingShingle Gowhar Wani
Ayesha Imran
Neeraj Dhawan
Anumodhan Gupta
Javed I Giri
Levetiracetam versus phenytoin in children with status epilepticus
Journal of Family Medicine and Primary Care
efficacy
levetiracetam
phenytoin
status epilepticus
title Levetiracetam versus phenytoin in children with status epilepticus
title_full Levetiracetam versus phenytoin in children with status epilepticus
title_fullStr Levetiracetam versus phenytoin in children with status epilepticus
title_full_unstemmed Levetiracetam versus phenytoin in children with status epilepticus
title_short Levetiracetam versus phenytoin in children with status epilepticus
title_sort levetiracetam versus phenytoin in children with status epilepticus
topic efficacy
levetiracetam
phenytoin
status epilepticus
url http://www.jfmpc.com/article.asp?issn=2249-4863;year=2019;volume=8;issue=10;spage=3367;epage=3371;aulast=Wani
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AT neerajdhawan levetiracetamversusphenytoininchildrenwithstatusepilepticus
AT anumodhangupta levetiracetamversusphenytoininchildrenwithstatusepilepticus
AT javedigiri levetiracetamversusphenytoininchildrenwithstatusepilepticus