A 27-year-old has ongoing bilateral tonic-clonic convulsions for seven minutes. Airway positioning and oxygen have been provided, capillary glucose

Question

A 27-year-old has ongoing bilateral tonic-clonic convulsions for seven minutes. Airway positioning and oxygen have been provided, capillary glucose is normal, and intravenous access has not yet been obtained. What is the most appropriate first-line medication?

Accepted Answer

Buccal midazolam while continuing airway support and preparing for escalation if seizures persist

Answer

Intravenous phenytoin as the initial medication before a benzodiazepine is considered

Answer

Subcutaneous insulin because normal capillary glucose does not exclude metabolic status epilepticus

Answer

Oral carbamazepine after the convulsions terminate and swallowing has been reassessed

Answer

Intravenous levetiracetam as the initial medication before any benzodiazepine is given

Convulsive status epilepticus — SCE Neurology MCQ

A 27-year-old has ongoing bilateral tonic-clonic convulsions for seven minutes. Airway positioning and oxygen have been provided, capillary glucose is normal, and intravenous access has not yet been obtained. What is the most appropriate first-line medication?