Habitually prolonged or repetitive seizures

A management plan is advised for patients with an established pattern of:

  • recurrent prolonged convulsive seizures (lasting 5 minutes or more)
  • serial seizures (three or more seizures in an hour).

In some cases, the plan may include advice for carers or relatives to give a benzodiazepine, to end the seizure or cluster of seizures. Drug choices include:

1 clobazam 20 to 30 mg (child 0.25 mg/kg) orally epilepsy, habitually prolonged or repetitive seizures    

OR (if the patient cannot safely swallow)

1 midazolam 5 to 10 mg (child: 0.2 to 0.3 mg/kg up to 10 mg) buccally or intranasally1. epilepsy, habitually prolonged or repetitive seizures midazolam    

The management plan should clearly state when urgent assessment at the nearest emergency department is needed.

1 Midazolam solution for injection (hydrochloride salt) can be given buccally or intranasally and may be provided under expert advice to parents and carers who have been trained in its use. Fact sheets that explain the method are available (eg from the Royal Children's Hospital Melbourne). Return