Levetiracetam versus phenytoin/fosphenytoin for second-line treatment of children with convulsive status epilepticus: an up-to-date meta-analysis and systematic review of randomized controlled trials
ObjectiveTo compare the efficacy and safety of levetiracetam versus phenytoin/fosphenytoin as second-line treatments in children with convulsive status epilepticus (CSE).MethodsA systematic search identified randomized controlled trials comparing levetiracetam with phenytoin/fosphenytoin to treat CS...
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Frontiers Media S.A.
2025-05-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2025.1580329/full |
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| author | Linping Jin Zhiping Jin Zhijiang Wang |
| author_facet | Linping Jin Zhiping Jin Zhijiang Wang |
| author_sort | Linping Jin |
| collection | DOAJ |
| description | ObjectiveTo compare the efficacy and safety of levetiracetam versus phenytoin/fosphenytoin as second-line treatments in children with convulsive status epilepticus (CSE).MethodsA systematic search identified randomized controlled trials comparing levetiracetam with phenytoin/fosphenytoin to treat CSE in children. Fourteen studies involving 2,197 patients were included in the meta-analysis.ResultsNo significant difference was found between the two treatments regarding seizure cessation (odds ratio (OR): 1.18, 95% confidence interval (CI): 0.94–1.48; p = 0.16) or time to clinical seizure termination (mean difference: −0.10, 95% CI: −0.61 to 0.40; p = 0.69). However, levetiracetam was associated with significantly fewer seizure recurrences (OR: 0.60, 95% CI: 0.43–0.84; p = 0.003) and adverse events (OR: 0.59, 95% CI: 0.37–0.94; p = 0.03) compared with phenytoin/fosphenytoin. No significant differences were observed in the need for mechanical ventilation, intensive care unit admission, or hospital length of stay.ConclusionLevetiracetam is as effective as phenytoin/fosphenytoin to control seizures in children with CSE and is associated with fewer seizure recurrences and adverse events. |
| format | Article |
| id | doaj-art-230a25d9cae14f7fb58841f6f83dee01 |
| institution | OA Journals |
| issn | 1664-2295 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Neurology |
| spelling | doaj-art-230a25d9cae14f7fb58841f6f83dee012025-08-20T02:01:24ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-05-011610.3389/fneur.2025.15803291580329Levetiracetam versus phenytoin/fosphenytoin for second-line treatment of children with convulsive status epilepticus: an up-to-date meta-analysis and systematic review of randomized controlled trialsLinping JinZhiping JinZhijiang WangObjectiveTo compare the efficacy and safety of levetiracetam versus phenytoin/fosphenytoin as second-line treatments in children with convulsive status epilepticus (CSE).MethodsA systematic search identified randomized controlled trials comparing levetiracetam with phenytoin/fosphenytoin to treat CSE in children. Fourteen studies involving 2,197 patients were included in the meta-analysis.ResultsNo significant difference was found between the two treatments regarding seizure cessation (odds ratio (OR): 1.18, 95% confidence interval (CI): 0.94–1.48; p = 0.16) or time to clinical seizure termination (mean difference: −0.10, 95% CI: −0.61 to 0.40; p = 0.69). However, levetiracetam was associated with significantly fewer seizure recurrences (OR: 0.60, 95% CI: 0.43–0.84; p = 0.003) and adverse events (OR: 0.59, 95% CI: 0.37–0.94; p = 0.03) compared with phenytoin/fosphenytoin. No significant differences were observed in the need for mechanical ventilation, intensive care unit admission, or hospital length of stay.ConclusionLevetiracetam is as effective as phenytoin/fosphenytoin to control seizures in children with CSE and is associated with fewer seizure recurrences and adverse events.https://www.frontiersin.org/articles/10.3389/fneur.2025.1580329/fullconvulsive status epilepticusphenytoinfosphenytoinlevetiracetamseizurereview |
| spellingShingle | Linping Jin Zhiping Jin Zhijiang Wang Levetiracetam versus phenytoin/fosphenytoin for second-line treatment of children with convulsive status epilepticus: an up-to-date meta-analysis and systematic review of randomized controlled trials Frontiers in Neurology convulsive status epilepticus phenytoin fosphenytoin levetiracetam seizure review |
| title | Levetiracetam versus phenytoin/fosphenytoin for second-line treatment of children with convulsive status epilepticus: an up-to-date meta-analysis and systematic review of randomized controlled trials |
| title_full | Levetiracetam versus phenytoin/fosphenytoin for second-line treatment of children with convulsive status epilepticus: an up-to-date meta-analysis and systematic review of randomized controlled trials |
| title_fullStr | Levetiracetam versus phenytoin/fosphenytoin for second-line treatment of children with convulsive status epilepticus: an up-to-date meta-analysis and systematic review of randomized controlled trials |
| title_full_unstemmed | Levetiracetam versus phenytoin/fosphenytoin for second-line treatment of children with convulsive status epilepticus: an up-to-date meta-analysis and systematic review of randomized controlled trials |
| title_short | Levetiracetam versus phenytoin/fosphenytoin for second-line treatment of children with convulsive status epilepticus: an up-to-date meta-analysis and systematic review of randomized controlled trials |
| title_sort | levetiracetam versus phenytoin fosphenytoin for second line treatment of children with convulsive status epilepticus an up to date meta analysis and systematic review of randomized controlled trials |
| topic | convulsive status epilepticus phenytoin fosphenytoin levetiracetam seizure review |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2025.1580329/full |
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