Two studies carried out in hospital EDs show that phenytoin and levetiracetam are equally effective as second-line therapy for convulsive status epilepticus in children.

The results provide the first randomised-controlled trial evidence to help decide between the two drugs when first-line therapy with benzodiazepines fails.

In the ConSEPT trial, 114 children presenting to 13 emergency departments in Australia and New Zealand were randomised to phenytoin (20mg/kg infusion over 20 minutes), and 119 were allocated to levetiracetam (40mg/kg infusion over five minutes).

The drugs were given at least 10 minutes after two attempts at first-line therapy had failed, reported the researchers who were led by Professor Franz Babl, group leader of emergency research at the Murdoch Children’s Research Institute in Melbourne.