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Convulsive status epilepticus — SCE Acute Medicine MCQ

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EasyAcute Neurological PresentationsConvulsive status epilepticusSCE Acute Medicine

A 51-year-old man has a witnessed generalised tonic-clonic seizure lasting eight minutes. He is still convulsing when the crash team arrives. Capillary glucose is 6.4 mmol/L, oxygen has been applied and IV access is available. What is the most appropriate immediate treatment?

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Correct answer: C — Give intravenous lorazepam

A convulsive seizure persisting beyond five minutes is status epilepticus and immediate benzodiazepine treatment is indicated. CT must wait until the airway and seizure are controlled. Phenytoin or levetiracetam is second-line if benzodiazepines fail. The key is to treat status epilepticus early, because delayed control worsens neuronal injury and airway risk.

Reference: NICE NG217, Resuscitation Council UK, BNF