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Paediatric seizure drug — DipIMC MCQ

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HardPaediatric and Obstetric EmergenciesPaediatric seizure drugDipIMC

An 8-year-old has continued convulsive status epilepticus despite two correctly dosed benzodiazepines. IV access is now established, resuscitation facilities are available and bedside glucose is normal. Which is the most appropriate next treatment class?

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Correct answer: C — Start intravenous second-line treatment with levetiracetam

The best answer is “Start intravenous second-line treatment with levetiracetam”. After two benzodiazepine doses fail, NICE recommends intravenous second-line antiseizure treatment with expert guidance; levetiracetam is one suitable option. Repeating benzodiazepines indefinitely increases respiratory risk, and oral medication or EEG confirmation would delay treatment. Choice among second-line agents requires local protocol, monitoring and paediatric expertise.

Reference: NICE NG217, Epilepsies: status epilepticus: https://www.nice.org.uk/guidance/ng217/chapter/7-Treating-status-epilepticus-repeated-or-cluster-seizures-and-prolonged-seizures