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How should we approach seizures in pediatric patients? How different is this from adults with seizures? We will discuss.
Great episode as always but I am concerned about some of the doses that you mentioned in your summary. As you alluded to, seizures have a kindling effect: they longer they go on, the more difficulty it is to stop the seizures. Specifically
The correct dose of levetiracetam is not 20 mg/kg but 60 mg/kg to maximum of 4500mg.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4749120/
The correct dosing of valproic acid in status epilepticus is 40mg/kg to maximum dose of 3000mg.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4749120/
There is a current multicenter trial examining the optimal 2nd line agent: Levetiracetam v. valproate v. fosphenytoin for status epilepticus
Would be happy to talk to you more about this subject as this is one of my interests.
Derek Isenberg, MD, FAAEMTemple UniversityReply
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