Muir Maxwell Epilepsy Centre, The University of Edinburgh and the Neurosciences Unit, Royal Hospital for Sick Children, Edinburgh, UK
Correspondence: Richard FM Chin
Muir Maxwell Epilepsy Centre,
20 Sylvan Place,
Edinburgh EH9 1UW, UK
Aetiology is the main determinant of morbidity and mortality in convulsive status epilepticus (CSE) but longer seizure durations may also increase risk of worse outcome. Thirty minutes of seizure activity is usually the time period used in longstanding definitions of CSE but it is not acceptable to wait for 30 minutes before treatment. Whilst intravenous therapy is best, pre-hospital treatment by a non-intravenous route is most practical in treating children. Benzodiazepines are the main class of first-line emergency antiepileptic drugs. This review will examine the available data on benzodiazepines according to: stability in the conditions of the emergency room services, drug absorption via non-intravenous route, clinical efficacy and safety, and ease of delivery and social acceptability.