A Comparative Study on Efficacy of Levetiracetam and Phenytoin in Pediatric Seizures

Epilepsy denotes a recurrent pattern of seizures, either with or without convulsions. Seizures are caused by an excessive discharge of cortical neurons (EEG).^[1] An epileptic patient will experience recurring seizures that start suddenly and end spontaneously^[2]. Epilepsy is typically reported to have a 1% incidence rate and a 2% prevalence rate.Epilepsy appears to be multifactorial or polygenic in nature from a genetic perspective.^[3] The age of the patient and the type of seizure determine the epilepsy's aetiology. The most frequent causes of hypoxia or birth asphyxia, cerebral injury during delivery, metabolic issues, congenital brain deformities, or infection in early infants^[4]. Seizures in this age group, especially in kids between 6 months and 5 years old, can happen in conjunction with a febrile illness.Seizures are referred to as "generalized"^[5] if they initially entail synchronous activation of both hemispheres of the brain. Loss of consciousness , muscle contractions are chief symptoms. Levetiracetam has the most significant mode of action is binding to the particular synaptic vesicle protein 2A. (SV2A). It  inhibits the release of vesicular neurotransmitters by binding to SV2A.Phenytoin minimizes the activity of brain stem regions important for the tonic phase of a tonic-clonic seizure and stops the focal location of a seizure from spreading. Based on study parameters Phenytoin has more notable positive effects than Levetiracetam in pediatric seizures

MATERIALS AND METHODS

AIM:A comparative study on efficacy of levetiracetam and phenytoin in pediatric seizures.

OBJECTIVE:

• To evaluate and compare the seizure control outcomes in pediatric patients treated with phenytoin and levetiracetam.
• To assess the clinical response and therapeutic effectiveness of both drugs in different types of epileptic seizures.
• To analyze the demographic and clinical characteristics of pediatric patients with epilepsy receiving treatment.
• To determine which drug shows superior efficacy in terms of seizure frequency reduction and overall clinical improvement.

MATERIALS AND METHODOLOGY:

The ethical approval of the study will be conducted only after the approval of the hospital committee. The study site of the research will be conducted at the pediatricsDepartmentof, DurgabaiDeshmukh Hospital, in Vidyanagar, Hyderabad. The duration of the study is proposed to be conducted for 1year.The design of the study is a Prospective observational study.The sample size taken is72-80 samplesA review of all the relevant and necessary data will be collected from patient’s record, laboratory records, by interviewing the patients and prescription.We have analyze the data using both inferential and descriptive statistics. Student t test (used for significant difference between two means).P value (<0.05 was statistically significant).Chi – square test (used for significant difference between the proportions).

RESULTS AND DISCUSSION:

1. Age:

Indicates that there was no discernible variation in medication usage by age group. In the Levetiracetam group, 49.3% were on the medication, whereas in the Phenytoin group, 50.7% were on the medication. Therefore, it is difficult to conclude which medication is more effective based on age distribution.

2. Gender:

Demonstrates that there was no statistically significant difference in the sex distributions of medication usage. Just 49.3 percent of those assigned to the Levetiracetam group and 50.7 percent of those assigned to the Phenytoin group actually took their prescribed medicine. Therefore, it is difficult to conclude which medication is more effective based on gender distribution.

3. Adverse effects:

Shows that there was no significant difference in the occurrence of side effects between the two medications. In the Levetiracetam group, 42% reported side effects, whereas in the Phenytoin group, 58% reported side effects. However, the difference was not significant, with a P value of 0.072.

4. Vitals:

Demonstrates that the two groups had similar baseline characteristics, suggesting that there was no intervention that may have altered the results. There was no discernible difference in the two groups; mean ages, weights, blood pressures, heart rates, or respiration rates. As a result, it is difficult to determine whether drug is superior based on initial conditions alone.

5. Temperature:

Demonstrates that neither group had significantly more cases of fever than the other. There was a higher incidence of fever in the Phenytoin group (39.1%) compared to the Levetiracetam group (60.9%). The P value for the difference was 0.184, which means that it was not statistically significant.

6. Lab investigations: