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

Hans Rosenberg
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.