HOW SHOULD SERIAL SEIZURES AND STATUS EPILEPTICUS BE TREATED?
• Convulsive status epilepticus (CSE) is a seizure or series of seizures lasting for at least 30 minutes. CSE carries risks of brain injury, organ failure or death. Prevention and early treatment are vital. • Early treatment of serial seizures and prolonged convulsions in the community is recommended. Primary care physicians and paramedics should be trained in the appropriate use of benzodiazepines. For susceptible patients there should be an agreed, individual written protocol identifying risk factors and early intervention. Their carers should be appropriately trained. • Rectal diazepam has enabled early intervention in the community but administration may be undignified and impractical. Buccal/nasal midazolam is unlicensed but appears to be effective, safe, and is preferred by patients and carers. It is already used particularly in older children and those with learning disability. It should be available for appropriate patients subject to specialist guidelines, protocols and traini
