Lyttle MD, et al. - For second-line management of pediatric convulsive status epilepticus, the most common pediatric neurological emergency worldwide, researchers compared the effectiveness and safety of phenytoin vs levetiracetam. In this multicenter, open-label, randomized trial involving 286 patients, participants aged 6 months to less than 18 years with convulsive status epilepticus requiring second-line treatment were randomly assigned (1:1) via a computer-generated randomization schedule to receive levetiracetam (40 mg/kg over 5 minutes) or phenytoin (20 mg/kg over at least 20 minutes). Levetiracetam was not significantly better than phenytoin, however earlier safety profiles that have been reported combined with the relative ease of administration indicate that it could be a suitable alternative to phenytoin as the first-choice, second-line anticonvulsant in the treatment of epileptic pediatric convulsive status.