ABSTRACT 329

Abstract

Background and aims: Status Epilepticus (SE) continues to be one of the most common pediatric acute care emergencies. Conventional SE protocols advocate Phenobarbitone as a second line antiepileptic drug (AED) if the child continues to seize even after Benzodiazepine (BZD) and Fosphenytoin (FPE) loading. Aims: We aimed to investigate the efficacy and safety of Levetiracetam as stage two AED in pediatric SE in place of phenobarbitone. Methods: Study design: Prospective observational study All consecutive children admitted to pediatric emergency during the study period (Jan 2012 to Nov 2013) received second stage AED Levetiracetam to control SE were included in the study to describe the safety and efficacy of Levetiracetam. Results: Of 111 children admitted with convulsive SE during the study period, 33 (36.7%) received Levetiracetam as stage two AED to achieve seizure control. Intravenous Levetiracetam at 30 mg/kg over 15 minutes followed by 10 mg/kg/dose as maintenance at 8 hourly interval was administered in all those enrolled. The mean age of presentation was 45.6 months [45.6(20.5–70.7)]. Among those received Levetiracetam, 22 children [67%; 22/33] had first episode seizure presenting as SE and 11 children [33%; 11/33] have had prior history of seizure. Levetiracetam had comparable efficacy (84%) and time to abort SE (16 min) to phenobarbitone as second stage AED without any side effects. Conclusions: This study concludes that Levetiracetam has comparable efficacy to be used as a second line AED in managing convulsive SE in infants and children with better side effect profile.