skip to main content

Convulsive status epilepticus — RACP Paediatrics MCQ

Instant feedback + full explanation. One question, done properly.

HardNeurology and neurodevelopmentConvulsive status epilepticusRACP Paediatrics

A 6-year-old has a generalised convulsive seizure lasting 18 minutes. Two doses of intravenous midazolam have been given; glucose is normal and the seizure continues with oxygen support in place. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Give a second-line intravenous antiseizure medicine and call anaesthetics/PICU

Ongoing convulsive status after appropriate benzodiazepines requires second-line IV therapy such as levetiracetam, phenytoin or valproate according to local protocol, with airway/PICU escalation. Repeated benzodiazepines increase respiratory depression without definitive seizure control. The pearl is to run status epilepticus as a timed algorithm with parallel airway, glucose and cause assessment.

Reference: RCH Clinical Practice Guidelines: Status epilepticus; Therapeutic Guidelines (eTG); AMH Children's Dosing Companion