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Year : 2018  |  Volume : 13  |  Issue : 2  |  Page : 158-164

IV Levetiracetam versus IV Phenytoin in childhood seizures: A randomized controlled trial

1 Department of Paediatrics, University College of Medical Sciences and GTB Hospital Delhi, India
2 Department of Neuropsychopharmacology, Institute of Human Behaviour and Allied Sciences Delhi, India

Correspondence Address:
Kanika Singh
101, Priya Enclave, Karkardooma, Delhi – 110092
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/JPN.JPN_126_17

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Objectives: To compare the efficacy of IV phenytoin and IV levetiracetam in acute seizures. Design: Randomized controlled trial. Setting: Tertiary care hospital, November 2012 to April 2014. Patients: 100 children aged 3–12 yrs of age presenting with acute seizures. Intervention: Participants randomly received either IV phenytoin 20mg/kg (n = 50) or IV levetiracetam 30mg/kg (n = 50). Patients who were had seizures at presentation received IV diazepam prior to these drugs. Outcome Measures: Primary: Absence of seizure activity within next 24 hrs. Secondary: Stopping of clinical seizure activity within 20 mins of first intervention, change in cardiorespiratory parameters, and achievement of therapeutic drug levels. Results: Two groups were comparable in patient characteristics and seizure type (P > 0.05). Of the 100 children, 3 in levetiracetam and 2 in phenytoin group had a repeat seizure in 24 hrs, efficacy was comparable (94% vs 96%, P > 0.05). Of these, 18 (36%) in phenytoin and 12 (24%) in levetiracetam group received diazepam. Sedation time was 178.80±97.534 mins in phenytoin and 145.50±105.208 mins in levetiracetam group (P = 0.346). Changes in cardiorespiratory parameters were similar in both groups except a lower diastolic blood pressure with phenytoin (P = 0.023). Therapeutic drug levels were achieved in 38 (76%) children both at 4 and 24 hrs with phenytoin, compared to 50 (100%) and 48 (98%) at 1 and 24 hrs with levetiracetam (P < 0.05). Conclusion: Intravenous levetiracetam and phenytoin have similar efficacy in preventing seizure recurrences for 24 hrs in children 3–12 years presenting with acute seizures.


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