Emergency Treatment with Levetiracetam or Phenytoin in Status Epilepticus in Children
Chief Investigator: Richard Appleton
Principle Investigator (LTHT): Dr Kerry Jeavons and Dr Alice Downes
Site: Leeds General Infirmary
This study is ran out of ED by the paediatric research team
Start Date: March 2016
End Date: March 2018
- Whether children with long lasting seizures should be treated with a medicine called phenytoin or levetiracetam (brand name Keppra) in an emergency setting.
- Phenytoin and Keppra are not new medicines and are already used in the treatment of children and young people who have seizures. However, it is currently not known which medication is better.
- To determine whether intravenous phenytoin or intravenous levetiracetam is a more effective second-line treatment for the emergency management of convulsive status epilepticus (CSE) in children.
- This is a randomised study
- Eligibility criteria
- Children aged 6 months – 18 years who present with a seizure which requires second line treatment.
- Presenting seizure is generalised tonic-clonic, generalised clonic or focal clonic status epilepticus that requires second-line treatment to terminate the seizure.
- First-line treatment administered according to APLS guidelines or the child’s personalised rescue care plan in order to try and terminate the presenting seizure.
- Exclusion Criteria
- Absence, myoclonic or non-convulsive status epilepticus, or infantile spasms.
- Known or suspected pregnancy.
- Known contra-indication or allergy to levetiracetam or phenytoin.
- This includes where the child’s personalised rescue care plan states that the child never responds to, or has previously experienced a severe adverse reaction to, phenytoin, levetiracetam, or both.
- Known renal failure (patients on peritoneal or haemodialysis or with renal function <50% expected for age)
- Previous administration of a second-line antiepileptic drug prior to arrival in the emergency department.
- Known to have previously been treated as part of EcLiPSE.