Kapur J, Elm J, Chamberlain JM, et al. - In a randomized, blinded, adaptive trial including children and adults with convulsive status epilepticus unresponsive to treatment with benzodiazepines, experts compared the efficacy and safety profiles of three intravenous anticonvulsive agents. A total of 384 people were recruited and randomized to receive levetiracetam (n = 145), fosphenytoin (n = 118), or valproate (n = 121). In all, relative to benzodiazepine-refractory convulsive status epilepticus, in nearly half of participants, levetiracetam, fosphenytoin, and valproate each resulted in cessation of a seizure and enhanced vigilance through 60 minutes. Furthermore, these three drugs were associated with comparable incidences of adverse events.