COMPARISON OF EFFICACY OF LEVETIRACETAM AND PHENYTOIN IN GENERALIZED STATUS EPILEPTICUS IN CHILDREN FROM AGE 6 MONTHS TO 5 YEARS

Abstract

Background: Status epilepticus is a critical neurological emergency in children requiring urgent treatment. Traditionally managed with phenytoin, recent studies show levetiracetam offers safer, easier use, though efficacy comparisons remain controversial, prompting this study to clarify outcomes and improve clinical decision-making.  

Objectives: To compare efficacy of levetiracetam and phenytoin in generalized status epilepticus in children from age 6 months to 5 years. 

Duration: Six months w.e.f 03-10-2024.

Methodology: After approval from the Hospital’s Ethical Review Board, 60 children who did not respond to two doses of midazolam were enrolled from the pediatric emergency unit at Ghurki Trust Teaching Hospital, Lahore. They were randomly divided into two groups: Group A received IV levetiracetam with a loading dose of 20 mg/kg and maintenance dosing, while Group B received IV phenytoin with a similar dosing protocol. All patients were managed by the same medical team, and data was recorded by a resident.  

Results: The study involved 60 children (mean age 31.72±14.18 months) evenly split into two age groups. Baseline characteristics were similar between Group A (levetiracetam) and Group B (phenytoin). Group A showed significantly higher seizure control at 24 hours (93.3% vs. 66.7%, p=0.010), with subgroup differences not statistically significant due to small sample sizes.

Conclusion: Levetiracetam showed significantly higher efficacy in preventing seizure recurrence within 24 hours compared to phenytoin in children aged 6 months to 5 years. Although subgroup differences were not statistically significant, levetiracetam appears to be a more effective treatment option.