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Medications for treating epileptic seizures in recovered children (Image Representative) & nbsp | & nbspPhoto: & nbspGetty Images
Washington DC: Researchers have recently discovered that the sequential prescription of two drugs, benzodiazepines and phenytoin, may help treat epileptic seizures in children. The study, published in The Lancet, shows that giving such drugs halves the number of children sent to intensive care.
Prolonged epileptic seizures are the most common neurological emergencies in children seen by hospitals. Seizures are life-threatening: up to 5% of affected children die and one-third suffer long-term complications from brain damage.
In case of severe seizures, first-line treatment (benzodiazepines) only ends seizures in 40-60% of patients. Prior to this study, anticonvulsant therapy was a second-line treatment for phenytoin, but this practice had not been studied extensively in a large randomized controlled trial. In addition, phenytoin was known to have a number of serious complications.
In this study, researchers compared phenytoin with levetiracetam, a newer anticonvulsant, for the second-line treatment of seizures. Levetiracetam is commonly used as a daily medication to prevent convulsions, but has not been subjected to an adequate test for phenytoin for the treatment of severe prolonged convulsions.
The research involved 233 children aged three months to 16 years. The researchers found that, individually administered, drugs are equally effective: both have a moderate success rate (50-60%) in stopping a prolonged attack.
But it is striking that treatment with one drug, then the other, has increased the success rate of a seizure to about 75%. Previously, children who continued to seize after phenytoin had to be intubated, sedated and placed under an intensive care ventilator.
"This study has now provided us with strong evidence for managing children with prolonged seizures without the need for intubation and intensive care," said Dr. Dalziel, principal investigator.
"By controlling crises in the emergency department, we will increase the chances that these children will recover more quickly and return to normal life," he added.
"This study will profoundly improve the treatment of children with severe epilepsy worldwide," said Professor Franz Babl, co-investigator.
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