<<The 2022 Lifelong Learning And Self-Assessment Study Guide, Table of Contents

Review 9: Randomized Trial of Three Anticonvulsant Medications for Status Epilepticus

Reviewer

Denise Marte, MD

Department of Emergency Medicine, Weill Cornell School of Medicine, New York, NY

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1. Article Citation
2. Synopsis
3. ABEM Quick Quiz
4. Discussion
5. Critique
6. References
7. Editor's Note
8. ABEM Quick Quiz Answers
9. Key Points
10. Original Article

Article Citation

Kapur J, Elm J, Chamberlain JM, et al. Randomized trial of three anticonvulsant medications for status epilepticus. N Engl J Med. 2019;381(22):2103-2113.

Synopsis

This randomized blinded trial compared intravenous (IV) levetiracetam, fosphenytoin, and valproate for the management of status epilepticus that is refractory to benzodiazepines. Primary outcomes included the absence of seizures and improved level of consciousness at 60 minutes after beginning treatment. During an interim analysis, it was determined that none of the drugs were inferior or superior, and the trial was stopped based on a rule for futility. The primary outcomes were reached in nearly half of all patients regardless of the medication utilized, and adverse outcomes were similar across the medications.

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