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Diazepam by continuous intravenous infusion for status epilepticus in anticonvulsant hypersensitivity syndrome
1Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, PA 15261.
Objective:
To report a case of status epilepticus in a patient with anticonvulsant hypersensitivity syndrome (AHS) that was controlled successfully using continuous intravenous infusion diazepam. AHS and alternatives for treatment of status epilepticus are also reviewed.
Design:
Single case report.
Setting:
217-bed children's university hospital.
Patient:
Four-year-old, 20-kg girl, diagnosed with idiopathic tonic-clonic epilepsy, who developed AHS to phenobarbital and phenytoin and status epilepticus unresponsive to lorazepam.
Results:
Diazepam intravenous infusion at dosages titrated to 8 mg/h was used successfully to control seizures for eight days until signs and symptoms of AHS had resolved and maintenance therapy with valproic acid was started.
Conclusions:
Continuous intravenous infusion diazepam is a reasonable therapeutic choice for the management of status epilepticus in a patient with AHS when traditional therapy such as phenytoin and phenobarbital cannot be used.