A 50-year-old woman on ICU is being treated with an IV midazolam infusion for refractory status epilepticus. She has been on the infusion for 72 hours...

Question

A 50-year-old woman on ICU is being treated with an IV midazolam infusion for refractory status epilepticus. She has been on the infusion for 72 hours targeting burst suppression on continuous EEG. The team plans to wean the infusion. What is the recommended approach?

Accepted Answer

Gradually reduce the midazolam infusion rate over 24-48 hours with continuous EEG monitoring, with antiepileptic drugs at therapeutic levels as background

Answer

Stop the midazolam infusion abruptly and observe for seizure recurrence

Answer

Switch directly to oral midazolam and discharge from ICU

Answer

Reduce midazolam to half the current rate and stop after 4 hours

Answer

Continue the midazolam infusion until the patient is seizure-free for 7 days

uk-fficm MCQ (SBA): Refractory Status Epilepticus

A 50-year-old woman on ICU is being treated with an IV midazolam infusion for refractory status epilepticus. She has been on the infusion for 72 hours targeting burst suppression on continuous EEG. The team plans to wean the infusion. What is the recommended approach?