What you need to know
In Australia, children who suffer from severe epileptic seizures now have access to a more effective treatment. The results of testing thus far could mean that the number of patients that are being seen in intensive care is about to halve.
As medical indemnity insurance experts, we want you to know about this new treatment and how it will significantly improve the success rate in stopping any seizure and in time potentially change how the condition is handled globally. The new survey was conducted by the Predict Research Group in 13 emergency wards in hospitals in New Zealand and Australia.
Revisiting traditional treatment
“In severe seizures, the first line of treatment (benzodiazepines) only stops the seizures in 40–60% of patients. Before this study, the second-line treatment was the anti-convulsant drug phenytoin, but until now this practice had never been scrutinised in a robust, major randomised controlled trial. Also, phenytoin was known to have a number of serious complications.”
Researchers compared phenytoin with newer anti-convulsant drug, levetiracetam for the second-line treatment of seizures. Levetiracetam is used routinely as a daily medication to prevent seizures, but has not been properly tested against phenytoin for treatment of severe prolonged seizures.
The researchers found that when given individually, the drugs are as good as each other: both had a moderate success rate (50–60%) at stopping a prolonged seizure. But strikingly, treatment with one drug and then the other increased the success rate of stopping a seizure to approximately 75%.
Previously, children who continued seizing after receiving phenytoin, then needed to be intubated, sedated and placed on a ventilator in intensive care. By giving these two medications one after the other, researchers have potentially halved the number of children ventilated and sent to intensive care.
“This study has now given us robust evidence to manage children with prolonged seizures without reverting to intubation and intensive care,” said Dr Stuart Dalziel, who is Professor of Emergency Medicine and Paediatrics in the Departments of Surgery and Paediatrics at the University of Auckland and a paediatric emergency medicine specialist at Auckland’s Starship Children’s Hospital.
“By controlling seizures in the emergency department, we will increase the chance of these children recovering more quickly and returning back to their normal lives,” he said. “This research has already changed practice and led to new guidelines in New Zealand and Australia.”
“This study is going to profoundly improve treatment for children who are critically ill with epilepsy around the world,” said Professor Franz Babl, who is also Professor of Paediatric Emergency Medicine at the University of Melbourne.
Tego Insurance Cares
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In Conclusion
The Tego Insurance team wants you to be informed about how and when to treat your patients. If you would like to learn more about this survey and Epilepsy, please contact us! Tego Insurance offers medical indemnity insurance and Medical Malpractice Insurance for medical practitioners. We have a profound understanding of the Australian medical profession and the ever-changing healthcare industry. It’s this expertise that allows us to provide leading cover with more choice, innovation and greater flexibility.
This publication is general in nature and is not comprehensive or constitute legal or medical advice. You should seek legal, medical or other professional advice before relying on any content, and practice proper clinical decision making with regard to individual circumstances. Persons implementing any recommendations contained in this publication must exercise their own independent skill or judgment or seek appropriate professional advice relevant to their own particular practice. Compliance with any recommendations will not in any way guarantee discharge of the duty of care owed to patients and others coming into contact with the health professional or practice. Tego Insurance Pty Ltd is not responsible to you or anyone else for any loss suffered in connection with the use of this information.