Evidence map›Paper›PMID 40739189›Full record

SynthesisBMC neurology2025

Efficacy and safety of levetiracetam for pediatric convulsive status epilepticus in emergency settings: a systematic review and meta-analysis.

Mohammed Alsabri, Sarah Makram Elsayed, Shree Rath, Hamza A Abdul-Hafez, Dina Essam Abo-Elnour, Elizabeth Kurian

Erratum issuedAbstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 6 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Review
  5. Article
  6. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors.

Mohammed AlsabriEmergency Department, Al-thawra Modern General Hospital, Sanaa, Yemen. alsabri5000@gmail.com.ORCID http://orcid.org/0000-0002-7278-2289
Sarah Makram ElsayedPediatrics Department, National Heart Institute, Giza, Egypt.
Shree RathAll India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, Odisha, India.ORCID http://orcid.org/0009-0000-4273-0827
Hamza A Abdul-HafezDepartment of Medicine, An-Najah National University, Nablus, West Bank, Palestine.
Dina Essam Abo-ElnourFaculty of Medicine, Zagazig University, Zagazig, Egypt.
Elizabeth KurianPediatric Emergency Department, Department of Pediatrics, St. Christopher's Hospital for Children, Philadelphia, PA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundStatus epilepticus is one of the most commonly occuring emergencies among children across the world. Time is crucial in the treatment of SE, with increasing risk of long term adverse events and sequelae with delay in treatment or action of drugs. This systematic review and meta-analysis aims to compare levetiracetam, a drug known for its comparatively safer profile, with other routinely used drugs in pediatric SE like phenytoin, fosphenytoin and valproate.

methodsA comprehensive literature search was conducted across four databases from 1996 till November 2024. All original studies evaluating the efficacy of levetiracetam vis-a-vis other anti-seizure medications in pediatric children in an emergency setting were included in the study. Data analysis was conducted using RevMan software, using a random-effects model.

resultsA total of fourteen studies, comprising a patient population of 2,473, were included for further quantitative analysis. No differences were noted between the drugs when comparing seizure termination and recurrence at 24 h. Levetiracetam notably reduced the time to cessation of seizures when compared to phenytoin or fosphenytoin (MD=-3.97, 5% CI [-6.18, -1.76], p = 0.0004) and length of ICU stay over phenytoin (MD = 0.77, 95% CI [0.54, 1.00], p < 0.00001). A lower risk of adverse events was noted on use of levetiracetam over fosphenytoin (RR = 0.62, 95% CI [0.40, 0.96], p = 0.03); however risk of agitation was the least on use of phenytoin (RR = 3.90, 95% CI [1.42, 10.73], p = 0.008). Non significant differences in mortality rates were observed.

conclusionThe study concludes better immediate effects of levetiracetam such as faster cessation of seizures. Levetiracetam was also suggested to stabilize patients faster, as implied by the lesser ICU stay and lower risk of adverse events. Further studies are needed to evaluate the efficacy of levetiracetam over other anti-seizure medications.

Indexed as

AnticonvulsantsLevetiracetamStatus EpilepticusChildEmergency Service, HospitalHumansPhenytoinTreatment OutcomeAnticonvulsantsLevetiracetamPhenytoinEmergency departmentEpilepsyLevetiracetamPediatricPhenytoinValproate

Identifiers

PMID40739189
PMCPMC12308964

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.