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Refractory Status Definition — RACP Paediatrics MCQ

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HardEmergency PaediatricsRefractory Status DefinitionRACP Paediatrics

A 10-year-old presents with status epilepticus that has been ongoing for 40 minutes despite two doses of benzodiazepine and a loading dose of IV phenytoin. Seizures continue. What is this classified as?

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Correct answer: E — Refractory status epilepticus

Refractory status epilepticus (RSE): seizures continuing despite adequate doses of first-line (benzodiazepines) and second-line (phenytoin, levetiracetam, or valproate) anti-seizure medications. RSE requires RSI with anaesthetic agents (thiopentone, midazolam infusion, or propofol) and continuous EEG monitoring in PICU.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Status Epilepticus