Managing paediatric convulsive status epilepticus : how useful is intravenous clonazepam?

Abstract

Any study in a paediatric population is not easy to design and implement, particularly in vulnerable children as a result of the often-catastrophic symptoms associated with convulsive status epilepticus (CSE). The child's guardians are frequently asked to consent, at very short notice, to a barrage of tests and therapies with uncertain results. Yet treatment must be urgently administered since it is well known that CSE, if untreated, may lead to severe neuropsychological impairments and a reduction in quality of life. The possible adverse long-term consequences with increased treatment resistance, morbidity, and mortality, leaves no option for all those involved, but to try and try again. In the absence of alternative options, benzodiazepines have been the mainstay of treatment for decades. Yet studies, to date, have mostly been limited to prospective observational adult cohorts and their use in paediatrics is largely based on anecdotal evidence.