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Phenytoin or paraldehyde as the second drug for convulsions in children

Three Part Question

In a [child continuing to fit after two doses of benzodiazepines] is [phenytoin or paraldehyde] more effective in [controlling seizure activity]?

Clinical Scenario

A fitting three year old child presents to the emergency department. The child has received an appropriate dose of rectal diazepam from the prehospital team. Following administration of a dose of intravenous lorazepam the child continues to fit. You wonder whether there is any evidence to suggest whether paraldehyde or phenytoin should be given next.

Search Strategy

Medline 1966 to 11/02 using the OVID interface.
({exp seizures OR seizure$.mp OR fit$.mp OR exp convulsions OR epilep$.mp OR exp epilepsy} AND {exp paraldehyde OR} AND { OR OR exp phenytoin}) LIMIT to human AND English

Search Outcome

44 papers found of which none were relevant to the original question.


There is no research in this area.

Clinical Bottom Line

Consensus guidelines should be followed.