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Volume 8 Issue 1 (January, 2020)

Original Articles

A comparative study of levetiracetam and fosphenytoin in the treatment of benzodiazepine- refractory status epilepticus in pediatric patients
Vinesh Kumar, Pankaj Mittal

Background: Status epilepticus (SE) is one of the most important neurological emergencies of pediatric age group. The present study was conducted to compare levetiracetam and fosphenytoin in the treatment of benzodiazepine refractory status epilepticus (BRSE) in pediatric patients. Materials & Methods: The present study was conducted on 84 pediatric cases of status epilepticus who were divided into 2 groups of 42 each. Group I patients received fosphenytoin at 20 mg/kg phenytoin equivalents (PE) dose and group II patients received levetiracetam at 40 mg/kg over 10 min. Time to terminate seizure (response latency) was measured. Primary and secondary outcome measures were recorded in all cases. Results: Type of seizures was GTCS 30 in group I and 32 in group II, focal seizure 7 in group I and 5 in group II, generalized tonic seizures 4 in group I and 3 in group II and myoclonic seizure 1 in group I and 2 in group II. Neuro-developmental status was normal seen in 34 in group I and 35 in group II, development delay 4 in group I and 2 in group II, static encephalopathy 3 in group I and 4 in group II, progressive encephalopathy 1 in group I. The need of additional anti-seizure medication was seen in 11 in group I and 5 in group II, time to termination of clinical seizure was 15.2 hours in group I and 13.4 hours in group II, duration of primary illness was 2.8 days in group I and 1.7 days in group II, number needing mechanical ventilation was 4 in group I and 3 in group II. Conclusion: Authors found that levetiracetam is an effective alternative to fosphenytoin in management of BRSE in pediatric population. Key words: fosphenytoin, levetiracetam, Status epilepticus

 
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