Effectiveness of Combined Levetiracetam and Midazolam in Generalized Convulsive Status Epilepticus in Children

Launched by SOHAG UNIVERSITY · Jun 14, 2021

Keywords

ClinConnect Summary

Generalized convulsive status epilepticus (GCSE) is a common pediatric neurological emergency with an annual incidence of up to 73 episodes per 100,000 children and is associated with mortality in 2.7% of cases and overall morbidity in 10% - 20% of cases, including hemodynamic instability and long-term neurological impairments.

The management of GCSE in children starts with emergency measures (stabilization phase) with monitoring and laboratory testing in the first 5 minutes. Benzodiazepines are used as first-line anticonvulsants for GCSE that persists for more than 5 minutes. However, stu...

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Eligibility criteria

• Inclusion Criteria:
• • Generalized convulsive status epilepticus, which is clinically defined at the time of presentation as continuous, generalized, tonic-clonic seizure activity or ≥ 2 generalized tonic-clonic seizures without recovery of consciousness for more than 5 minutes.
• Exclusion Criteria:
• • Failure to obtain informed consent.
• • Prior therapy with any anticonvulsant for the presenting episode of generalized convulsive status epilepticus.
• • Epileptic patients on levetiracetam therapy.
• • Known allergy or contraindications to any of the study drugs.
• • End-stage kidney disease.
• • Severe liver disease.
• • Cardiac diseases.
• • Hypoglycemia or hyperglycemia.
• • Inborn errors of metabolism.
• • Known mood/behavioral disorder.
• • Failure to obtain intravenous access in the first 5 minutes.
• • Cessation of seizures during the stabilization phase (0 - 5 minutes).
• • Traumatic brain injury