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Paediatric Status Epilepticus Debate

Welcome back – as promised this is the bonus segment that was too good to leave in the Journal Club this month. Justin and I invited Dr Damian Roland back onto the podcast to discuss the new evidence which may guide our management of status epilepticus in children.

Dr Damian Roland is an Emergency Paediatric Physician who has a special interest in research into the super sick kids in ED. Damian infamously lost a piece of Lego in his alimentary tract last year. He is a leader in Paeds research and works in the PERUKI network to bring us excellent studies such as these.

In case you were not aware – both Eclipse and Consept trial were published recently and they were widely debated online and in tea rooms all over the world.

This discussion between Damian and Justin dives deeply into the meaning of these trials. They talk about how the actual study methodology effects our interpretation and Justin shares his strategy for dealing with “sick” status epilepticus kids in the first 20 minutes ( I know – he is supposed to stick tot he First 10….)

Full texts of the original papers are available here – so you can do your own analysis:

Levetiracetam versus phenytoin for second-line treatment
of convulsive status epilepticus in children (ConSEPT):
an open-label, multicentre, randomised controlled trial

Stuart R Dalziel, Meredith L Borland… Lancet, April 2019

Levetiracetam versus phenytoin for second-line treatment
of paediatric convulsive status epilepticus (EcLiPSE):
a multicentre, open-label, randomised trial

Mark D Lyttle, Naomi E A Rainford… Lancet, April 2019

Justin and Damian also mention a few other studies which are pertinent to the debate. If you want to read more on these – check out the various write-ups over at First10EM for a comprehensive analysis. Links below:

Aggressive seizure algorithm: why I use propofol earlF

Phenobarbital second line in status epilepticus (Burman 2019)

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