ABSTRACT
Persistent seizure or repeated seizures without full recovery between episodes; operationally defined as a seizure lasting longer than 5 minutes or two seizures between which there is incomplete recovery of consciousness. Neuronal death after 30 to 60 minutes of continuous seizure activity. Benzodiazepines are often given first because of their rapid onset and ease of delivery; their effectiveness is limited by sedation/respiratory depression Lorazepam and diazepam have similar onsets, but diazepam has a shorter half-life because it is redistributed out of the Central nervous system; diazepam may also be given per rectum. Fosphenytoin may be given more rapidly than phenytoin, although the time to onset of clinical effect is similar. New-onset or inadequately controlled chronic epilepsy: change in anticonvulsant drug levels; intercurrent infection or metabolic abnormality; ethanol excess, or withdrawal.
