Status Epilepticus 

Continuous seizure activity > 5-10 min OR >= 2 seizures without full recovery

First line 

• Lorazepam 2-4 mg IV 

• Diazepam 5-10 mg IV 

• Midazolam 2-4 mg IV (10 mg IM if no IV access) 

Second line 

• Phenytoin or fosphenytoin 20 mg/kg IV 

  (Phenytoin max infusion 50 mg/min) 

  (Fosphenytoin max infusion 150 mg/min) 

• Valproic acid 20 mg/kg IV 

• Phenobarbital 20 mg/kg IV at 50 mg/minute 

• Levetiracetam 2,000-4,000 mg over 15 min 

Third line 

• Pentobarbital (5-15 mg/kg bolus then 0.5-10 mg/kg/hr infusion) 

• Propofol (3-5 mg/kg bolus then 1-15 mg/kg/hr infusion 

#Status #Epilepticus #Management #Neurology #Epilepsy