{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T22:53:32Z","timestamp":1761519212881,"version":"3.37.3"},"reference-count":30,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,1,24]],"date-time":"2018-01-24T00:00:00Z","timestamp":1516752000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:sec><jats:label\/><jats:p>Since the 1970s, intravenous (<jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content>) phenytoin (<jats:styled-content style=\"fixed-case\">PHT<\/jats:styled-content>) has traditionally been used as second\u2010stage treatment for convulsive status epilepticus (<jats:styled-content style=\"fixed-case\">SE<\/jats:styled-content>) after failure of benzodiazepines. The aim of this review was to critically assess the evidence supporting the use of <jats:styled-content style=\"fixed-case\">IV PHT<\/jats:styled-content> as treatment of convulsive <jats:styled-content style=\"fixed-case\">SE<\/jats:styled-content> in patients of any age. In particular, we critically appraised the results of randomized controlled trials (<jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>s) evaluating <jats:styled-content style=\"fixed-case\">IV PHT<\/jats:styled-content> as treatment of convulsive <jats:styled-content style=\"fixed-case\">SE<\/jats:styled-content>. A systematic search of the literature was carried out to identify <jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>s evaluating <jats:styled-content style=\"fixed-case\">IV PHT<\/jats:styled-content> as treatment of convulsive <jats:styled-content style=\"fixed-case\">SE<\/jats:styled-content> in patients of any age. Eight <jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>s (544 patients allocated to <jats:styled-content style=\"fixed-case\">IV PHT<\/jats:styled-content>) were included. The included studies differed in almost every single characteristic considered. Six <jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>s (472 patients) used <jats:styled-content style=\"fixed-case\">IV PHT<\/jats:styled-content> without demonstrating refractoriness of <jats:styled-content style=\"fixed-case\">SE<\/jats:styled-content> to benzodiazepines. Only two <jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>s (72 patients) used <jats:styled-content style=\"fixed-case\">IV PHT<\/jats:styled-content> as second\u2010line treatment for benzodiazepine\u2010resistant convulsive <jats:styled-content style=\"fixed-case\">SE<\/jats:styled-content>. Overall, most evidence from <jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>s supports the use of <jats:styled-content style=\"fixed-case\">IV PHT<\/jats:styled-content> immediately after <jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content> diazepam, even if seizures have not recurred. The recommendation derived from <jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>s supporting the use of <jats:styled-content style=\"fixed-case\">IV PHT<\/jats:styled-content> as second\u2010line treatment in benzodiazepine\u2010resistant convulsive <jats:styled-content style=\"fixed-case\">SE<\/jats:styled-content> is weak. This is emblematic of the lack of robust evidence from large <jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>s to inform clinical practice on how to treat <jats:styled-content style=\"fixed-case\">SE<\/jats:styled-content> after failure of first\u2010line drugs. <jats:styled-content style=\"fixed-case\">IV PHT<\/jats:styled-content> given immediately after first\u2010line benzodiazepines could prolong their short antiepileptic effect and prevent seizure recurrence.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.13560","type":"journal-article","created":{"date-parts":[[2017,12,30]],"date-time":"2017-12-30T07:12:42Z","timestamp":1514617962000},"page":"451-463","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["A critical appraisal of randomized controlled trials on intravenous phenytoin in convulsive status epilepticus"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0928-1577","authenticated-orcid":false,"given":"F.","family":"Brigo","sequence":"first","affiliation":[{"name":"Department of Neurosciences Biomedicine and Movement Sciences University of Verona Verona"},{"name":"Department of Neurology Franz Tappeiner Hospital Merano"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N. L.","family":"Bragazzi","sequence":"additional","affiliation":[{"name":"School of Public Health Department of Health Sciences (DISSAL) University of Genoa Genoa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8748-0083","authenticated-orcid":false,"given":"S.","family":"Lattanzi","sequence":"additional","affiliation":[{"name":"Neurological Clinic Marche Polytechnic University Ancona Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Nardone","sequence":"additional","affiliation":[{"name":"Department of Neurology Franz Tappeiner Hospital Merano"},{"name":"Department of Neurology Christian Doppler Klinik Paracelsus Medical University Salzburg"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Trinka","sequence":"additional","affiliation":[{"name":"Department of Neurology Christian Doppler Klinik Paracelsus Medical University Salzburg"},{"name":"Center for Cognitive Neuroscience Salzburg"},{"name":"Public Health, Health Services Research and HTA University for Health Sciences Medical Informatics and Technology Hall in Tirol Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,1,24]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.13121"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1331.2004.00943.x"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneurpsyc.1958.02340020016003"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.18.6.513"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-015-0454-2"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1517\/14656566.2016.1127354"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1331.2006.01397.x"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2006.00870.x"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-012-9695-z"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2007.04.012"},{"volume-title":"Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011)","year":"2011","author":"Higgins JPT","key":"e_1_2_7_12_1"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.38.2.202"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199809173391202"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000224880.35053.26"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0404.2008.01097.x"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejpn.2009.02.004"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2014.12.013"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eplepsyres.2015.04.013"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2008.01706_3.x"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2013.12.007"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1331.2011.03606.x"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40263-014-0167-1"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2016.09.030"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.13775"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0149-2918(96)80051-8"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1592\/phco.19.10.844.31556"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1592\/phco.20.11.908.35269"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2003.10.011"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2011.03237.x"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.12288"}],"container-title":["European Journal of Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fene.13560","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ene.13560","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ene.13560","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ene.13560","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T09:06:49Z","timestamp":1693300009000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ene.13560"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,1,24]]},"references-count":30,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2018,3]]}},"alternative-id":["10.1111\/ene.13560"],"URL":"https:\/\/doi.org\/10.1111\/ene.13560","archive":["Portico"],"relation":{},"ISSN":["1351-5101","1468-1331"],"issn-type":[{"type":"print","value":"1351-5101"},{"type":"electronic","value":"1468-1331"}],"subject":[],"published":{"date-parts":[[2018,1,24]]},"assertion":[{"value":"2017-10-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-12-27","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-01-24","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}