Study finds improved medication for treating epileptic seizures in children

Researchers have recently found that prescribing two medications -benzodiazepines and phenytoin - one after the other, could help treat epileptic seizures in children.

The study, published in the journal The Lancet, shows that giving said medications halved the number of children sent to intensive care.

Prolonged epileptic seizures are the most common neurological emergencies in children seen by hospitals. The seizures are potentially fatal: up to five per cent of affected children die, and a third suffer long-term complications from brain damage.

In severe seizures, the first line of treatment (benzodiazepines) only stops the seizures in 40 to 60 per cent of patients. Before this study, the second line treatment was the anticonvulsant drug phenytoin, but until now this practice had never been scrutinised in a robust major randomised controlled trial. Also, phenytoin was known to have a number of serious complications.

In this study, researchers compared phenytoin with newer anti-convulsant levetiracetam for second line treatment of seizures.

Levetiracetam is used routinely as a daily medication to prevent seizures but has not been properly tested against phenytoin for treatment of severe prolonged seizures.

The research involved 233 child patients aged between three months and 16 years. Researchers found that when given individually, the drugs are as good as each other: both had a moderate success rate (50-60 per cent) at stopping a prolonged seizure.

But strikingly, treatment with one drug and then the other increased the success rate of stopping a seizure to approximately 75 per cent.

Previously, children who continued seizing after phenytoin then needed to be intubated, sedated and placed on a ventilator in intensive care.

"This study has now given us robust evidence to manage children with prolonged seizures without reverting to intubation and intensive care," said Dr. Dalziel, lead researcher.

"By controlling seizures in the emergency department we will increase the chance of these children recovering more quickly and returning back to their normal lives," he added.

"This study is going to profoundly improve treatment for children who are critically ill with epilepsy around the world," said Professor Franz Babl, co-researcher.