Mental health

Antiepileptic drugs for acute convulsive seizures or status epilepticus in adults and children

Question 2: In adults and children with acute convulsive seizures or status epilepticus, when IV access is available, which IV antiepileptic drugs when compared to placebo/comparator produce benefits/harm in the specified outcomes?

Management of epilepsy

  • Population: adults and children presenting with status epilepticus or acute convulsive seizures
  • Interventions:
    • IV diazepam
    • IV phenobarbital
    • IV lorazepam
    • IV phenytoin
  • Comparison: one intervention versus other
  • Outcomes:
    • non-cessation of seizures
    • death
    • adverse effects including requirement for ventilatory support
    • neurocognitive impairment (long-term).

Recommendation(s)

In convulsive status epilepticus, IV benzodiazepine (lorazepam or diazepam) should be administered. If available, IV lorazepam is preferred over IV diazepam.
Strength of recommendation: STRONG

For sustained control or if seizures continue after benzodiazepines administration, IV phenobarbital or phenytoin should be administered.
Strength of recommendation: STRONG

Evidence profile

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