Are there alternatives to Lorazepam?
Intavenous lorazepam 4mg is the best choice for status in hospital but if there is a delay in obtaining lorazepam then iv 10mg diazemuls (or buccal midazolam 10mg) can be used. Rectal diazepam (stesolid) 10mg is very useful out of hospital to prevent further seizures What about non epileptic status? A proportion of patients with apparent status will be having non-epileptic (pseudo-)seizures. These patients need to be assessed and discussed on an individual basis. Important information to gather includes: vital signs and physical examination, blood gases and oximetry (acidosis and hypoxia indicate organic disease), urgent EEG. If you strongly suspect pseudoseizures then you should involve the neurology team early. If in doubt treat as genuine status epilepticus.
