Run Time: 2 minutes

Author: Samuel Killian M.D.

Educational Pearls:

• First line of treatment for status epilepticus is benzodiazepines. Typically two doses of 4mg of ativan is given for adults and 0.1 mg per kg is given for children.
• Second, think P! Try one of either phenytoin, fosphenytoin, phenobarbital, and keppra, given at about 15-20 mg per kg depending on the specific drug used. If not working, try your second favorite.
• As the third line of treatment, consider a versed drip, propofol, barbiturate coma, and start thinking about giving pyridoxine for possible ingestion. These patients are typically intubated and will usually require a continuous EEG to monitor for continued seizure activity.

References:  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2824929/