HTAHealth Technology Assessment NHS R&D HTA Programme www.hta.ac.uk HTAHow to obtain copies of this and other HTA Programme reports. An electronic version of this publication, in Adobe Acrobat format, is available for downloading free of charge for personal use from the HTA website (http://www.hta.ac.uk). A fully searchable CD-ROM is also available (see below).Printed copies of HTA monographs cost £20 each (post and packing free in the UK) to both public and private sector purchasers from our Despatch Agents.Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per monograph and for the rest of the world £3 per monograph.You can order HTA monographs from our Despatch Agents:-fax (with credit card or official purchase order) -post (with credit card or official purchase order or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you either to pay securely by credit card or to print out your order and then post or fax it. Contact details are as follows: Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to Direct Mail Works Ltd and drawn on a bank with a UK address. Paying by credit cardThe following cards are accepted by phone, fax, post or via the website ordering pages: Delta, Eurocard, Mastercard, Solo, Switch and Visa. We advise against sending credit card details in a plain email. Paying by official purchase orderYou can post or fax these, but they must be from public bodies (i.e. NHS or universities) within the UK. We cannot at present accept purchase orders from commercial companies or from outside the UK. How do I get a copy of HTA on CD?Please use the form on the HTA website (www.hta.ac.uk/htacd.htm). Or contact Direct Mail Works (see contact details above) by email, post, fax or phone. HTA on CD is currently free of charge worldwide. Declared competing interests of authors: AG Marson has received speaker fees and reimbursement for attending conferences from Jannsen Cilag, Glaxo SmithKline, Novartis, Pfizer and Sanofi Synthelabo and research funding from Pfizer. DW Chadwick has received consultancy fees, speaker fees and reimbursement for attending conferences from Jannsen Cilag, Glaxo SmithKline, Novartis, Pfizer and Sanofi Synthelabo. DF Smith has received speaker fees and reimbursement for attending conferences from Jannsen Cilag, Glaxo SmithKline, Novartis, Pfizer and Sanofi Synthelabo and research funding from Glaxo SmithKline. R Appleton has received consultancy fees, speaker fees and reimbursement for attending conferences from Jannsen Cilag, Glaxo SmithKline and Sanofi Synthelabo. GA Baker has received research funding, speaker fees and reimbursement for attending conferences from Jannsen Cilag, Glaxo SmithKline, Novartis, Pfizer and Sanofi Synthelabo. A Jacoby has received research funding from Sanofi Synthelabo, GSK and Janssen-Cilag and has acted as a research consultant to Johnson and Johnson Pharmaceuticals. Published October 2007This report shoul...

SUMMARY Lorazepam was compared with diazepam for the treatment of acute convulsions and status epilepticus in 102 children in a prospective, open, ‘odd and even dates’ trial. Convulsions were controlled in 76 per cent of patients treated with a single dose of lorazepam and 51 per cent of patients treated with a single dose of diazepam. Significantly fewer patients treated with lorazepam required additional anticonvulsants to terminate the seizure. Respiratory depression occurred in 3 per cent of lorazepam‐treated patients and 15 per cent of diazepam‐treated patients. No patient who received lorazepam required admission to the intensive care unit for either respiratory depression or persisting status epilepticus. Rectally administered lorazepam appeared to be particularly valuable (100 per cent efficacy) when venous access was not possible. RÉSUMÉ Lorazepam vs diazepam dans le Tretirement aigu des crises comitiales el de L'étal de mat épileptique Le lorazepam a été comparé au diazepam dans lc traitement aigu de convulsions et de L'et at de mal épileptique chcz 102 enfants, dans une étude prospective, ouverte, en essais ‘jours pairs et impairs.’ Les convulsions furent eontrolées chez 76 pour cent des patients tradés par lorazepam et 51 pour cent des patients traités par diazepam. Significativement moins de patients traités par lorazepam exigérent des anticomitiaux complémentaires pour terminer la crise. Une dépression respiratoire se manifesta chez 3 pour cent des patients traités par lorazepam et 15 pour cent des patients traités par diazepam. Aucun des patients traités par lorazepam n'exigércnt une admission dans une unité de soins intensifs pour dépression respiratoire ou persistance d'un etal de mal. Le lorazepam administré par voic rectalc semble particuliércment efficace (100 pour cent d'efficacité) lorsqul'il n'y a pas les conditions d'une injection intra‐veincusc. ZUSAMMENFASSUNG Lorazepam versus Diazepam bei der Akutversorung von epileptischen Anjâilen mid Status epilepticus Bei 102 Kindern wurde in einer prospektiven offenen ‘odd and even dates’ Studie Lorazepam mit Diazepam bei der Behandlung von akulen Anfällen und des Status epilepticus verglichen. Bei 76 Prozent der mit Lorazepam und bei 51 Prozent der mit Diazepam bchandelten Patientcn konnten die Anfälle untcr Kontrolle gebracht werden. Von den mit Lorazepam behandelten Patienten brauchten signifikant weniger zusätzlichc Antikonvulsiva, urn die Anfälle zu stoppen. Eine Atemdepression wurde unter Lorazepam nur bei 3 Prozent unter Diazepam bei 15 Prozent der Patienten beobachtet. Kein Patient, der mit Lorazepam behandelt wurde, mußte weder wegen einer Atemdepression noch wegen eines anhaltenden Status epilepticus auf die Intensivstation aufgenommen werden. Rcktal verabreichtes Lorazepam schien besonders geeignet (100 Prozent Wirksamkeit), wenn ein venöser Zugang nicht möglich war. RESUMEN Lorazepam versus diazepam en el tratamiento agudo de crisis epilepsias y ‘status epilepticus’ Se comparó el lorazepam con el diazepam en el tratamiento de las conv...

Corticosteroids (predominantly prednisolone and hydrocortisone) and adrenocorticotropic hormone (ACTH) have been used in the treatment of the epilepsies for over 50 years. 1 2 Over the past 30 years most reports have focused on epilepsy syndromes and epileptic encephalopathies resistant to treatment with the more conventional anticonvulsant and antiepileptic drugs (AEDs) and specifically West syndrome. There has been relatively little attention on the role of corticosteroids in treating other epilepsies.

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This observational study has confirmed previous data that intravenous levetiracetam seems to be effective and safe in the treatment of acute repeated seizures and status epilepticus. A randomised clinical trial is justified to determine whether intravenous levetiracetam should replace intravenous phenytoin as the first long-acting anticonvulsant in the management of acute repetitive seizures and status epilepticus.