An update in the initial management of paediatric status epilepticus : Current Opinion in Pediatrics

Secondary Logo

Journal Logo

EMERGENCY AND CRITICAL CARE MEDICINE: Edited by Jean Klig and Clifford W. Bogue

An update in the initial management of paediatric status epilepticus

Lawton, Bena,b,c; Davis, Tessad; Goldstein, Henrya,b; Tagg, Andrewe

Author Information
Current Opinion in Pediatrics 30(3):p 359-363, June 2018. | DOI: 10.1097/MOP.0000000000000616


Purpose of review 

Over the last 2 years, algorithms for the optimal management of status epilepticus have changed, as the medical community has recognized the need to terminate seizures in status in a timely manner. Recent research has evaluated the different choices of benzodiazepine and has given consideration to second-line treatment options.

Recent findings 

There has been a move to examine alternatives to phenytoin (such as levetiracetam and lacosamide) as second-line agents. Valproate should be used cautiously in view of the potential side effects. Three ongoing trials [Established Staus Epilepticus Treatment Trial (ESETT), Convulsive Status Epilepticus Paediatric Trial (ConSEPT), and emergency treatment with levetiracetam or phenytoin in status epilepticus in children (EcLiPSE)] are comparing the efficacy of levetiracetam and phenytoin.


Benzodiazepines remain the first-line agent of choice, although there is ongoing discussion about the mode of administration and the best drug to choose. The results of ESETT, ConSEPT, and EcLiPSE will affect our future management of status, as we give consideration to levetiracetam as an alternative to phenytoin. Other medications such as lacosamide may emerge in future algorithms too.

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

You can read the full text of this article if you:

Access through Ovid