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Convulsive status epilepticus — RCPSC EM MCQ

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HardNeurological emergenciesConvulsive status epilepticusRCPSC EM

A 7-year-old has continuous generalized tonic-clonic seizure activity for 9 minutes. Glucose is normal, oxygenation is supported and IV access has just been obtained. What is the most appropriate next treatment?

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Correct answer: C — Give IV lorazepam and prepare a second-line antiseizure load

The best answer is “Give IV lorazepam and prepare a second-line antiseizure load”. Convulsive activity lasting at least 5 minutes is treated as status epilepticus. An adequate benzodiazepine dose should be given promptly while the team prepares second-line treatment if it persists. Imaging investigates cause after immediate seizure control; routine pre-emptive intubation and oral therapy delay time-critical care.

Reference: Canadian Paediatric Society: Emergency management of paediatric convulsive status epilepticus: https://cps.ca/en/documents/position/emergency-management-of-the-paediatric-patient-with-convulsive-status-epilepticus