Methodology: 4/5
Usefulness: 4/5

Lyttle MD, et al. Lancet. 2019 May 25;393(10186):2125-2134.

Question and Methods: Eclipse was an open label RCT that evaluated time to seizure cessation in pediatric SE between Keppra and Dilantin

Findings: They found that Keppra was not superior (HR 1.2, 95%CI 0.91-1.60, p= 0.20) to Dilantin for the treatment of SE

Limitations: Limited somewhat by study design, lack of blinding and a lower dose of Keppra then used in our institution.

Interpretation: This study adds to a growing body of literature that Keppra may be as effective as Phenytoin/Fosphenytoin as a second line treatment in the management of SE in pediatric patients, which is a recent trend in treatment in the ED in Canada.

By: Dr. Harrison Charmichael

Author

  • Dr. Rosenberg is an emergency physician at the Ottawa Hospital, assistant professor at the University of Ottawa, and Director of the Digital Scholarship and Knowledge Dissemination Program.