Sodium valproate vs phenytoin in status epilepticus: A pilot study

Mechanistic and pharmacologic aspects of status epilepticus and its treatment with new antiepileptic drugs

“…This barely reached statistical significance (p < 0.05). However, the choice of a one-sided Fisher's exact test has been criticized (Rossetti, 2007), since the authors had no way of predicting which drug would be better. A two-sided test would show no significant difference.…”

What is the relative value of the standard anticonvulsants: Phenytoin and fosphenytoin, phenobarbital, valproate, and levetiracetam?

“…One study compared intravenous VPA with intravenous PHE as first-line treatment (Misra et al, 2006). The results favor intravenous VPA (66% vs. 42%), but the study has low statistical power [calculated 95% confidence intervals (CIs) were (50-81%) vs. (26-59%); number needed to treat 4.3 (2.2-429.9)] and an inappropriate use of onesided t-test (Rossetti, 2007). Another study investigated 40 children with refractory SE (aged 5-12 years) (Mehta et al, 2007).…”

Non-convulsive status epilepticus in adults - an overview

“…Nevertheless, some countries (Norway, Canada, Singapore) approved the drug on "summative, use-proven evidence"; i/v VPA was lately approved for the treatment of GCSE also in Germany after recommendations upon an extensive review of an expert panel [260]. A randomised double-blind pilot trial, using PHT or VPA as first-line treatment before administration of benzodiazepines, showed a trend to superiority of VPA against PHT; however, the study was underpowered and statistically flawed; thus, these results should be interpreted with caution and further studies are warranted [261,262]. Most recently, a controlled randomised prospective trial comparing i/v VPA with i/v PHT (n = 50 in each group) after failure of BD has shown a significantly superior efficacy of VPA compared to PHT (p >0.05); the study also reiterated the importance of a treatment as soon as possible [263].…”