Benzodiazepines are potent anticonvulsants that are commonly used intravenously and occasionally rectally to treat status epilepticus.23 Diazepam, midazolam, clonazepam, and lorazepam are all used as AEDs.48 Diazepam rectal gel is effective in controlling acute repetitive seizures (clusters). Intravenous midazolam drip may be more effective for refractory status than other benzodiazepines56 and may represent a substantial improvement over other therapeutic approaches, such as pentobarbital anesthesia.57
Paradoxically, diazepam may induce seizures in patients with Lennox-Gastaut syndrome and lower the seizure threshold in epilepsy patients receiving enflurane.58
Reviewed and revised April 2004 by Steven C. Schachter, MD, epilepsy.com Editorial Board.
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