علاج الخط الأول للصرع التشنجي المستمر

References

DOI: 10.5698/1535-7597-16.1.48

• The initial therapy phase should begin when the seizure duration reaches 5 minutes and should conclude by the 20-minute mark when response (or lack of response) to initial therapy should be apparent.
• A benzodiazepine (specifically IM midazolam, IV lorazepam, or IV diazepam) is recommended as the initial therapy of choice, given their demonstrated efficacy, safety, and tolerability (level A, four class I RCTs).
• For prehospital settings or where the three first-line benzodiazepine options are not available, rectal diazepam, intranasal midazolam, and buccal midazolam are reasonable initial therapy alternatives (level B).
• Initial therapy should be administered as an adequate single full dose rather than broken into multiple smaller doses.