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Lorazepam in status epilepticus.

J E Walker, R W Homan, M R Vasko

    Annals of Neurology
    |September 1, 1979
    PubMed
    Summary
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    Lorazepam effectively controlled status epilepticus in 22 of 25 patients. This benzodiazepine demonstrated a longer duration of seizure control compared to diazepam, with minimal complications.

    Area of Science:

    • Pharmacology
    • Neurology
    • Clinical Medicine

    Background:

    • Lorazepam is a benzodiazepine with demonstrated anticonvulsant properties in animal models.
    • It exhibits minimal respiratory and circulatory depressant effects in humans.
    • Status epilepticus is a neurological emergency requiring effective and safe treatment.

    Purpose of the Study:

    • To evaluate the efficacy and safety of intravenous lorazepam in treating status epilepticus.
    • To compare the duration of seizure control with lorazepam versus diazepam.
    • To establish therapeutic plasma concentrations of lorazepam for seizure control.

    Main Methods:

    • Twenty-five patients with status epilepticus received intravenous lorazepam (4 or 8 mg).
    • Seizure control, recurrence, and adverse events were monitored.

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  • Plasma lorazepam levels were measured to correlate with seizure control.

    • Main Results:

    • Intravenous lorazepam controlled status epilepticus in 22 out of 25 patients.
    • A single transient respiratory arrest occurred in one patient; no other significant complications were noted.
    • Therapeutic plasma concentrations for seizure control were estimated between 30 and 100 ng/mL.

    Conclusions:

    • Lorazepam is an effective and safe treatment for status epilepticus.
    • It provides a longer duration of seizure control than diazepam.
    • Repetitive injections are generally not needed for sustained seizure control once initially achieved.