[Anti-convulsant therapy]

Treatment for seizures during acute encephalopathy and encephalitis is not so different from those for seizures due to other etiologies. However, it is sometimes accompanied with intensive care and we also have to pay attention to consciousness disturbance, because it is difficult to determine whether consciousness disturbance is caused by encephalopathy itself, or effect of anticonvulsant therapy, especially in early stage of acute encephalopathy. In Japanese guideline of treatment for influenza encephalopathy, an intravenous administration of diazepam or midazolam as first-line agent, phenobarbital or phenytoin as second-line agent, and midazolam (continuous) or thiopental as third-line agent, were recommended for therapy for status epilepticus.