87 people a day are diagnosed with epilepsy in the United Kingdom (UK)—this equals 600,000 people. With the diagnosis comes other conditions such as the possibility of memory loss and other cognitive issues. A new study led by the University of Liverpool and Alder Hey Children’s Hospital Trust reveal a user friendly treatment for the most common life-threatening neurological emergency in children.
Epilepsy In the UK has an annual incidence of 20 per 100,000 children, and represents the second most common reason for unplanned admission to pediatric intensive care units (PICUs) in the UK. Anti-epileptic drugs (AEDs)—known as anticonvulsants, are used to control seizures. However, convulsive status epilepticus (CSE) is the situation when a tonic-clonic seizure doesn’t stop either stop on its own or with anticonvulsants. This represents the most life-threatening neurological emergency in children.
Presently, CSE is treated using an algorithm which incorporates 10 min intervals between treatments. Second-line treatment is given when CSE persists either after two doses or the first-line treatment, which is an anticonvulsant called benzodiazepine, or the child’s personalized emergency (rescue) treatment.
Researchers have found that a medication known as levetiracetam could be an effective and safer alternative to phenytoin, another anticonvulsant.
EcLiPSE Team (Study)
The EcLiPSE Team is led by Professor Richard Appleton, a Merseyside paediatric neurologist based at the University of Liverpool’s Department of Women’s and Children’s Health, and Alder Hey Children’s Hospital Trust.
The study team sought to ascertain which treatment was safest and most effective. The EcLiPSE Team, made up of doctors from Alder Hey and Bristol Children’s Hospitals together with research teams from the Universities of Liverpool and the West of England, conducted a trial to compare the efficacy and safety of both drugs and for second-line management of CSE. The team conducted a randomize clinical trial involving 30 UK Emergency Departments and almost 300 children between 2014 and 2018.
The results did not show that levetiracetam was better than phenytoin, in stopping CSE. However, overall the results suggest levetiracetam may be considered as an alternative treatment to phenytoin.
Professor Richard Appleton said: “The EcLiPSE trial has given doctors new and unique evidence for the choice of anticonvulsant and how to best treat this childhood neurological emergency.
This study was funded in part by PERUKI (Paediatric Emergency Research in the UK and Ireland) and funded by the National Institute for Health Research (NIHR) HTA (Health Technology Assessment) programme.