What is the first-line treatment for status epilepticus?

The first-line treatment for status epilepticus is benzodiazepines, primarily because they act quickly to enhance the inhibitory neurotransmission mediated by gamma-aminobutyric acid (GABA), providing rapid control of seizures. Benzodiazepines such as lorazepam or diazepam are often administered intravenously for this purpose, as they can considerably decrease the frequency of ongoing seizure activity.

In cases of status epilepticus, timely intervention is crucial, as prolonged seizures can lead to significant morbidity, including neuronal injury and mortality. Benzodiazepines are favored due to their effectiveness and the speed at which they can induce sedation and seizure cessation. Subsequent management may involve other antiepileptics to prevent recurrence, but the immediate priority is the rapid cessation of active seizure activity, which benzodiazepines achieve effectively.

While other medications mentioned may also have a role in the management of seizures, they are not the initial drugs of choice in an acute setting. Fosphenytoin and phenobarbital may be used in the stabilization phase after benzodiazepines, but their onset of action is slower. Levetiracetam, although effective in general anticonvulsant therapy, is not recommended as the first agent in urgent