Lyttle MD, et al. - In the second-line management of pediatric patients (aged 6 months to under 18 years) with convulsive status epilepticus, researchers conducted this open-label, randomized clinical trial comparing phenytoin to levetiracetam regarding their effectiveness and safety. Out of 1,432 patients from 30 UK emergency departments at secondary and tertiary care centers, 286 were randomized to receive treatment, after exclusion of ineligible; 152 were given levetiracetam, and 134 were given phenytoin. Together with formerly reported safety profiles and the relative ease of administration with levetiracetam, findings of this trial suggest that despite non-significant superiority of levetiracetam to phenytoin, it could be an appropriate alternative to phenytoin as the first-choice, second-line anticonvulsant in the treatment of pediatric convulsive status epilepticus.