A 25-year-old woman presents with continuous generalized tonic-clonic seizure activity for 12 minutes without regaining consciousness. IV access is established. What is the first-line drug and route?
- A IV lorazepam ✓
- B IV phenytoin infusion
- C IV phenobarbital
- D IV levetiracetam
Correct answer: A. IV lorazepam
Explanation
Status epilepticus is defined as seizure lasting more than 5 minutes or recurrent seizures without recovery. First-line treatment is a benzodiazepine, with IV lorazepam preferred for its rapid onset and longer duration of action compared to diazepam. Phenytoin or fosphenytoin is second-line. Phenobarbital is third-line. Levetiracetam is used as an adjunct.
Reference: Neurology (AAN/ILAE guidelines), 2016 ed.
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