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Few studies have documented the relative efficacy of common treatments for status epilepticus. This five-year trial randomized 518 patients with status epilepticus to receive lorazepam (0.1 mg/kg), phenobarbital (15 mg/kg), phenytoin (18 mg/kg), or diazepam (0.15 mg/kg) followed by phenytoin (18 mg/kg). Success was defined as cessation of motor and electroencephalographic seizure activity 20 minutes after beginning drug infusion.
Among 384 patients with overt generalized convulsive status epilepticus, success rates were 64.9% for lorazepam, 58.2% for phenobarbital, 43.6% for phenytoin, and 55.8% for diazepam plus phenytoin. Lorazepam was significantly more effective than phenytoin (p=0.002).
In 134 patients with subtle generalized convulsive …