Phenytoin and levetiracetam are equally effective second-line treatments for status epilepticus

Design : The 'Convulsive Status Epilepticus Paediatric Trial' (ConSEPT) was an open label randomised controlled trial. Allocation : 1:1 computer-generated block randomisation, stratified by site and age. Setting : 13 emergency departments (ED) in New Zealand and Australia (8 tertiary paediatric EDs). Patients : 234 children aged 3 months to 16 years presenting with convulsive status epilepticus. Patients had already received two doses of benzodiazepines. Intervention : Levetiracetam 40 mg/kg over 5 min intravenous or intraosseous. Comparison : Phenytoin 20 mg/kg over 20 min intravenous/intraosseous. The participant was assessed 5 min after the infusion had finished; if seizure activity was present, the other study medication was also given. A video was used to independently assess the time of seizure cessation. Primary outcomes : Clinical cessation of seizure activity 5 min after infusion completion. Secondary outcomes : Clinical cessation of seizures 2 hours after infusion of 1 or 2 drugs, need for rapid sequence induction, time to seizure cessation, intensive care unit admission, serious adverse events, seizure status …