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Status epilepticus — MCCQE Part 1 MCQ

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EasyAcute CareStatus epilepticusMCCQE Part 1

37-year-old man with epilepsy presents with continuous generalized seizure for 7 minutes. He has not regained consciousness and glucose is normal. Which of the following is the most appropriate next step?

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Correct answer: E — Give benzodiazepine immediately and escalate to second-line antiseizure therapy if ongoing

Give benzodiazepine immediately and escalate to second-line antiseizure therapy if ongoing is best because seizure lasting beyond 5 minutes is status epilepticus. Wait for confirmatory testing before any stabilisation is suboptimal because resuscitation and time-critical treatment should not wait when instability is present; Discharge once symptoms temporarily improve is suboptimal because temporary improvement can precede deterioration; Give an adjunctive medication as the sole first-line treatment is suboptimal because adjuncts do not replace definitive stabilisation; Delay escalation until cardiac arrest or respiratory failure occurs is suboptimal because early escalation is central to emergency care. Check glucose, but do not delay benzodiazepines.

Reference: Canadian neurological/emergency guidance