Status epilepticus
- Treat convulsive SE immediately
- 1st: adequate-dose benzodiazepine
- IV lorazepam; IM midazolam if no IV
- Then load a maintenance ASM promptly
- LEV, valproate or fosphenytoin
- Similar efficacy among those 3 options
- Refractory SE → ICU anesthetic + EEG
Use at a glance
- Treat convulsive SE immediately
Escalation / refractory disease
- Refractory SE → ICU anesthetic + EEG
Practical pearls
- Similar efficacy among those 3 options
Choosing treatment
- 1st: adequate-dose benzodiazepine
- IV lorazepam; IM midazolam if no IV
Other practical pearls
- Then load a maintenance ASM promptly
- LEV, valproate or fosphenytoin
Self-check
- What is the first drug treatment for convulsive status epilepticus?
An adequate-dose benzodiazepine. - What treats refractory status epilepticus?
ICU anesthetic + EEG.
Drugs used for this (5)
All clinical uses · Open Status epilepticus in the interactive console ↗