A 30-year-old woman is admitted to ICU with refractory convulsive status epilepticus. She received IV lorazepam 4 mg twice pre-hospital, then IV pheny...

Question

A 30-year-old woman is admitted to ICU with refractory convulsive status epilepticus. She received IV lorazepam 4 mg twice pre-hospital, then IV phenytoin 20 mg/kg loading dose in the emergency department. Seizures continue 30 minutes after phenytoin completion. What is the most appropriate next step?

Accepted Answer

Intubate and commence IV midazolam or propofol infusion for general anaesthesia

Answer

Repeat IV lorazepam 4 mg

Answer

Administer IV levetiracetam 60 mg/kg (max 4.5 g)

Answer

Administer IV sodium valproate 40 mg/kg

Answer

Commence IV phenobarbitone 15 mg/kg

uk-fficm MCQ (SBA): Refractory Status Epilepticus