Status epilepticus is a neurological emergency. Mortality for adults is ~20%. The goal of treatment is rapid termination of behavioral and electrical seizure activity; the longer the episode of status epilepticus is untreated, the more difficult it is to control and the greater the risk of permanent brain damage. Critical to the management are a clear plan, prompt treatment with effective drugs in adequate doses, and attention to hypoventilation and hypotension. Since the high doses of drugs used may cause hypoventilation, it may be necessary to assist respiration temporarily. Drugs should be administered intravenously. Four regimens have similar success rates of 44—65%: diazepam followed by phenytoin; lorazepam; phenobarbital; and phenytoin alone. Studies show no significant differences with respect to recurrences or adverse reactions.
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