ESETT

Randomized Trial of Three Anticonvulsant Medications for Status Epilepticus
Kapur. NEJM 2019; 381:2103-13

Clinical Question
-  In patients with status epilepticus who have been treated with benzodiazepines, is Levetriracetam, Valproate or Fosphenyoin more likely to lead to an absence of seizures and improved responsiveness at 60 minutes?

N = 720, 57 EDs in USA

Authors’ Conclusions
In benzodiazepine-refractory convulsive status epilepticus, the anticonvulsant drugs levetiracetam, fosphenytoin, and valproate each led to seizure cessation and improved alertness by 60 minutes in approximately half the patients, and the three drugs were associated with similar incidence of adverse events