Background Status epilepticus is a neurological emergency and is refractory to standard treatment at times. New antiepileptic drugs have been introduced but the place of application of these drugs in status is yet to be established.
Objective To compare efficacy and adverse effects of intravenous Valproate and intravenous Levetiracetam as second line anti-epileptic drugs in status epilepticus to intravenous Phenytoin.
Methodology 42 patients between 6 months to 12 years presenting with status epilepticus were included in the study and randomly distributed in three groups depending on the day of admission and each group was assigned one of three drugs under study as second line anti-epileptic drug. The ability of the drug to stop convulsions as well as time taken to stop convulsions and adverse effects were noted. Analysis of the data was done using chi square test.
Results 57% patients studied for phenytoin(12/21), 63% for valproate(7/11) and 80% for levitracetam(8/10) became non convulsive after the use of respective drugs. But on applying chi-square test, p value showed that the comparison was not significant. The average time taken to stop convulsions by phenytoin is 10 min, valproate is 10 min and by levetiracetam is 11 min, which again was not statistically significant. Only 2 out of 42(4.7%) developed minor adverse effects from phenytoin in the form of excessive drowsiness and irritability.
Conclusion Clinically the efficacy of i.v. levetiracetam and i.v. valproate was found to be better than i.v. phenytoin but no statistically significant difference was observed. So phenytoin remains the preferred second-line anti-convulsant in status epilepticus with minimal side-effects.