Status Epilepticus

Intravenous diazepam or lorazepam is usually effective in terminating attacks and providing short-term control. For prolonged therapy, intravenous phenytoin has often been used because it is highly effective and less sedating than benzodiazepines or barbiturates. However, phenytoin may cause cardiotoxicity (perhaps because of its solvent, propylene glycol), and fosphenytoin (watersoluble) is a safer parenteral agent. Phenobarbital has also been used in status epilepticus, especially in children. In very severe status epilepticus that does not respond to these measures, general anesthesia may be used.