Seizure Therapy if Benzo fails!

PGY1 PGY2 PGY3 PGY4 Seizure

We know the first approach to seizure usually is benzodiazepines after ABC, but in status epiliepticus we should start another agent to control patient’s seizure activity that does not stop or have a breakthrough. NEJM in a RCT of 3 AED reported that levetiracetam, fosphenytoin, and valproate each:

  1. could stop seizure activity in half of patients who did not respond to benzo.
  2. could improve alertness within 60 minutes
  3. same adverse effect among aformentioned medication

Link to Abstract