Lorazepam was compared with diazepam for the treatment of status epilepticus in a double-blind, randomized trial. Seventy-eight patients with 81 episodes were enrolled. Patients received one or two doses of either 4 mg of lorazepam or 10 mg of diazepam intravenously. Seizures were controlled in 89% of the episodes treated with lorazepam and in 76% treated with diazepam. The times for onset of action of the medications did not differ significantly. Adverse effects occurred in 13% of the lorazepam-treated patients and in 12% of the diazepam-treated patients. Respiratory depression and arrest, the most frequent adverse effects, were treated symptomatically; no adverse sequelae were noted.
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Use of benzodiazepines in patients with status epilepticus requiring second-line antiseizure medication treatment.
Epilepsy Res
January 2025
Department of Neurology, Vaasa Central Hospital, Vaasa, Finland.
Background: Status epilepticus (SE) is a life-threatening state that needs rapid and adequate treatment. Benzodiazepines (BZD) are used as a first-line treatment for SE, and if the desired effect is not achieved, second-line antiseizure medications are used.
Objective: To investigate whether the treatment with BZDs is performed adequately in patients with different subtypes of SE requiring second-line ASM treatment and, if not, to identify the factors influencing the suboptimal treatment.
Post-marketing safety of antiseizure medications: Focus on serious adverse effects including drug reaction with eosinophilia and systemic symptoms (DRESS).
Seizure
January 2025
Department of Pharmacy Practice, Auburn University Harrison College of Pharmacy, Auburn, AL 36049, United States.
Purpose: On November 28, 2023, the U.S. FDA issued a Drug Safety Communication, warning that antiseizure medications (ASMs) levetiracetam and clobazam can cause a rare but serious reaction, drug reaction with eosinophilia and systemic symptoms (DRESS).
View Article and Find Full Text PDFStrategies to innovate emergency care of status epilepticus.
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December 2024
Department of Neurology and Neuroscience Brain Institute University of Virginia, School of Medicine, Health Sciences Center, Box 801330, Charlottesville, VA 22908-1330, USA. Electronic address:
Generalized Convulsive status epilepticus (SE) is a neurological emergency because prolonged convulsions can cause respiratory compromise and neuronal injury. Compromised GABA-mediated inhibition is a defining feature of SE, and many current therapies are benzodiazepines, which are allosteric modulators of GABA-A receptors. Many patients with medically refractory epilepsy are at risk for SE.
View Article and Find Full Text PDFJapanese guidelines for treatment of pediatric status epilepticus - 2023.
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Working Group for the Revision of Treatment Guidelines for Pediatric Status Epilepticus/Convulsive Status Epilepticus, Japanese Society of Child Neurology, Tokyo, Japan; Committee for Integration of Guidelines, Japanese Society of Child Neurology, Tokyo, Japan; Division of Child Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Yonago, Japan.
Article Synopsis
- The 2015 updated definition of status epilepticus (SE) emphasizes the importance of early treatment, identifying key time points for diagnosis and management.
- Japan has revised its pediatric SE treatment guidelines, recommending buccal midazolam for pre-hospital and in-hospital treatment when intravenous access is not possible, while benzodiazepines are preferred when intravenous access is available.
- The updated guidelines note similarities in seizure cessation rates across different medications, highlight the need for further recommendations on nonconvulsive status epilepticus (NCSE), and plan to explore the effects of NCSE treatment on children's outcomes in future editions.
Association between psychopharmacotherapy and postpartum hemorrhage.
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Northwell, New Hyde Park, NY (Jackson, Kouba, Meirowitz, Keller, Bracero, and Blitz).
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