Emergency medication
Most people’s seizures last the same length of time each time they happen and usually stop by themselves. However, sometimes seizures do not stop or one seizure follows another without the person recovering in between. When a seizure goes on for 5 minutes or more it is called status epilepticus (or ‘status’ for short).
Status during a tonic clonic (convulsive) seizure is a medical emergency and needs urgent treatment with emergency medication.
Treatment
The two emergency medications used to prevent status in the community (outside of the hospital setting) are midazolam and diazepam:
- Buccal (oromucosal) midazolam – is given into the buccal cavity (the side of the mouth between the cheek and the gum).
- Rectal diazepam – is given rectally (into the bottom).
Both these drugs are sedatives. Sedative drugs have a calming effect on the brain and can stop a seizure. Although it is rare, these emergency drugs can cause breathing difficulties so the person must be closely watched until they have fully recovered.
For people who have gone into status before, their doctor may prescribe midazolam or diazepam so that a carer can give it to them. Specialist training is needed to give emergency medication. It is also important that every individual who is prescribed diazepam or midazolam has a written plan (or protocol) about when they are given the medication.
A protocol includes specific information relating to a person’s medical condition. It is usually completed with or on behalf of someone with epilepsy and can include details about their medication, for example the dose, when to give it, and when to call for emergency help. You can download a sample protocol here. (Protocol by kind permission of Veriton Pharma Ltd)
Training
Epilepsy Society can provide training in giving emergency medication.
Information produced January 2023