ESETT trial

A medical research study to learn how to treat patients with a type of prolonged seizures in the emergency department was recently completed, and Mass General was one of the participating hospitals.

There are three treatment options commonly used by doctors in the emergency room to treat patients with refractory status epilepticus, severe seizures that continue even after benzodiazepine medications, which are effective in controlling seizures in more than two-thirds of patients.

New findings published in the New England Journal of Medicine reveal that the three drugs—levetiracetam, fosphenytoin, and valproate—are equally safe and effective in treating patients with this condition. The study was supported by the National Institute of Neurological Disorders and Stroke (NINDS), part of the National Institutes of Health.

Before the study, doctors didn't know what medicine worked best. The study showed that three medicines commonly used to treat prolonged seizures all work similarly well, stopping seizures about half the time in both children and adults. The medicines were also similar in safety. These results give doctors more flexibility and confidence when treating patients with prolonged seizures.

The researchers thank the MGH community for their support of this emergency research conducted with exception from consent. This was a heroic effort combining teams from neurology (led by Dr. Eric Rosenthal), emergency medicine (led by Dr. Joshua Goldstein), and included both adult and pediatric participants.

The study, called the Established Status Epilepticus Treatment Trial, or ESETT, was published in the November 28, 2019 issue of the New England Journal of Medicine. The study was funded by the National Institutes of Health.

To learn more about the research and the results visit the ESETT website.