5. Treatment of status epilepticus

Page created on February 8, 2022. Not updated since.


Status epilepticus is defined as either:

  • Ongoing seizure activity (> 30 minutes)
  • Repetitive seizures for greater than 30 minutes without recovery of consciousness in between

However, because of poor prognosis, treatment is initiated if the seizure persists for more than 5 minutes (we don’t wait for 30 minutes).


  • Drug intoxication
  • Drug withdrawal
  • Hypoglycaemia
  • Electrolyte imbalance
  • Head trauma
  • Infection
  • Ischaemic stroke
  • Intracranial haemorrhage
  • Metabolic disorders
  • Hypoxia
  • Epilepsy

Treatment of status epilepticus

  • 0th step: ABC
  • 1st step: Benzodiazepine
    • If vascular access: IV 0,2 – 0,5 mg/kg diazepam (or midazolam or lorazepam)
    • If not: i.m. midazolam or buccal midazolam or rectal diazepam
  • 2nd step: Repeat benzo doze
  • 3rd step: Antiepileptic
    • Phenytoin or fosphenytoin or levetiracetam or valproate or phenobarbital
  • 4th step: General anaesthesia

Leave a Reply

Inputting your name is optional. All comments are anonymous.