Generalized Convulsive Status Epilepsy Case Study

One major aspect concerning the management of generalized convulsive status epilepticus is deciding which benzodiazepine should be used for treatment. “A seizure can represent an abrupt and transient occurrence of signs and/or symptoms resulting from an abnormal, excessive discharge from an aggregate of neurons in the brain.”1 If the seizure is continuous over a period it can be described as status epilepticus. Since the brain is so complex and seizure activity involves several neurons, many antiepileptic drugs act primarily by preventing the spread of nerve impulse along the axon of a neuron.1 Benzodiazepines are most commonly used for termination of status epilepticus because it has the most rapid onset of action compared to the other anticinvulsants.2 The goal of treatment is to gain control of the seizure with minimal side effects from the medication.2
The first study designed examined includes a randomized, double-blind trial conducted by Alldredge and colleagues. The purpose of this trial was to “evaluate intravenous benzodiazepines administered by paramedics for the treatment of out-of-hospital status epilepticus.”3 Adults with status epilepticus were given 5mg of diazepam, 2 mg of lorazepam, or placebo.3 The drug was administered only during generalized tonic-clonic seizure activity but if the seizure continued for four minutes or more after the first injections, the patients were given another injection.3 The results were as followed: upon arrival at the emergency department, 59.1% of patients that were given lorazepam, 42.6% of patients given diazepam, and 21.1% of patients given placebo seizure activity was terminated.3 Lorazepam showed to be a little bit more than effective than diazepam but they both were clinically efficient for treating status