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Refractory convulsive status epilepticus — SCE Acute Medicine MCQ

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HardNeurology and ophthalmologyRefractory convulsive status epilepticusSCE Acute Medicine

A 26-year-old woman with known epilepsy has recurrent seizures despite two doses of IV lorazepam. She is intubated for airway protection. Blood glucose and sodium are normal. What is the most appropriate next antiseizure treatment?

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Correct answer: C — Load an intravenous second-line antiseizure medicine

Ongoing convulsive status after adequate benzodiazepine treatment requires a protocolled intravenous second-line antiseizure drug, such as levetiracetam, phenytoin or valproate. Choice depends on comorbidity, pregnancy potential, interactions and local protocol. Airway support and correction of reversible causes continue in parallel; EEG should not delay treatment.

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