Treatment of status epilepticus with lorazepam
R. J. Levy and R. L. Krall
Twenty-one episodes of status epilepticus (SE) were each treated with 1 to
9 mg (mean, 4 mg) of intravenous lorazepam. All patients with generalized
tonic-clonic ( GTC ) SE responded within 15 minutes. Nine (82%) of the 11
patients with episodes of partial SE with altered responsiveness responded
poorly. Respiratory depression occurred in five instances (two requiring
intubation) and was associated with transient loss of brain-stem reflexes,
hypotension, and decorticate posturing in three cases. Generalized
tonic-clonic SE was transformed into partial SE with altered responsiveness
in three patients. In an additional four patients, marked lethargy
developed. Lorazepam appears effective in controlling GTC SE but only
occasionally effective in partial SE with altered responsiveness.
