Effectiveness of Levetiracetam Versus Phenytoin in Acute Management of Childhood Seizures

Rabia Khalid; Amjad Iqbal; Talal Waqar; Muzammil Ghafoor; Amir Aslam Awan; Hafsa Ejaz

doi:10.51253/pafmj.v76i3.12175

Authors

Rabia Khalid Department of Paediatrics, Combined Military Hospital Abbottabad /National University of Medical Sciences (NUMS) Pakistan
Amjad Iqbal Department of Paediatrics, Combined Military Hospital Abbottabad /National University of Medical Sciences (NUMS) Pakistan
Talal Waqar Department of Paediatrics, Combined Military Hospital Kharian /National University of Medical Sciences (NUMS) Pakistan
Muzammil Department of Paediatrics, Combined Military Hospital Bannu /National University of Medical Sciences (NUMS) Pakistan
Amir Aslam Awan Department of Paediatrics, Combined Military Hospital Multan/National University of Medical Sciences (NUMS) Pakistan
Hafsa Ejaz Department of Paediatrics, Combined Military Hospital Lahore/National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v76i3.12175

Keywords:

Anticonvulsants, Levetiracetam, Pediatrics, Phenytoin, Seizures

Abstract

Objective: To compare the antiseizure efficacy of Levetiracetam versus Phenytoin in acute management of childhood seizures.

Study Design: Quasi-experimental Study

Place and Duration of Study: Pediatric Unit, Combined Military Hospital, Abbottabad, Pakistan, from Aug 23 to Jan 24.

Methodology: Pediatric patients (0-28 days, 2 months-5 years, and 6-12 years age) presenting with acute seizures or first fit of life not yet attributed to any underlying cause were included in the study. Employing a non-probability consecutive sampling technique, 70 patients were recruited in Group-L, who received Levetiracetam, and 70 patients in Group-P who received phenytoin. Recorded parameters included demographics, cardiovascular parameters, duration of seizure, recurrence of seizures in 24 hours, and duration of sedation.

Results: A total of 140 patients were recruited with a male-to-female ratio of 3.2:1. Efficacy of both drugs as revealed by seizure duration with a median value of 7.3(5.4-14.5) minutes in Group-L as compared to 14.2(9.7-17.5) minutes in Group-P (p-value 0.001). Recurrence of seizures during 24 hours was observed in 03(4.3%) patients in Group-L as compared to 05(7.1%) patients in Group-P (p-value 0.466). Comparison of side effects among groups revealed that bradycardia, hypotension, and arrhythmia events occurred more in Group-P as compared to Group L. At the same time, the duration of sedation was significantly greater in Group-L compared to Group-P (p-value 0.001).

Conclusion: Levetiracetam and phenytoin are both effective in acute pediatric seizures with a better safety profile of Levetiracetam as compared to phenytoin.

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