ABSTRACT
Generalized major-motor status epilepticus is a neurologic emergency that requires immediate attention to cardiorespiratory function followed by prompt and effective pharmacologic intervention. Various lines of evidence, both from clinical and experimental investigations, suggest that neuronal injury in status epilepticus can arise from the prolonged abnormal electrical activity itself, i.e., even in the absence of overt convulsions. It is essential to realize that the treatment of status epilepticus with neuromuscular blockade is not sufficient. Diazepam is often considered the initial drug of choice for the treatment of status epileptics, at least in settings where potential side effects, such as hypoventilation, can be adequately managed. Lorazepam has become increasingly popular as a useful alternative to diazepam in the initial therapy of status epilepticus. Because of its effectiveness and long duration of action, phenytoin has been suggested as initial therapy for status epilepticus.
