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High-dose intravenous lorazepam for the treatment of refractory status epilepticus

Department of Neurology, Comprehensive Epilepsy Center, New York Hospital-Cornell Medical Center, New York, NY.

We treated nine refractory status epilepticus cases with high-dose intravenous lorazepam. We monitored the EEGs continuously, and lorazepam dosing was titrated to stop clinical and electrographic seizures. Lorazepam doses needed to terminate status epilepticus ranged from 0.3 to 9 mg/hr. Lorazepam did not cause hypotension. All patients survived. Outcome was complete recovery in two cases, moderate disability in four, and severe disability in three. These findings suggest high-dose intravenous lorazepam may be an effective alternative to pentobarbital for the treatment of severe status epilepticus.

Address correspondence and reprint requests to Dr. Douglas R. Labar, Comprehensive Epilepsy Center, New York Hospital-Cornell Medical Center, K-619, 525 East 68th Street, New York, NY 10021.

Received November 10, 1993. Accepted in final form January 26, 1994.

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