This NIHR Systematic Review programme funded evidence synthesis assesses the current evidence on the clinical and cost-effectiveness of treatments for convulsive status epilepticus in the pre-hospital setting. Convulsive status epilepticus is a medical emergency that requires prompt treatment to ensure optimal patient recovery. It is defined as five or more minutes of either continuous seizure activity or repetitive seizures without gaining consciousness. Benzodiazepines are currently used as first-line treatment of status epilepticus; these include buccal midazolam or rectal diazepam or intravenous (IV) lorazepam if IV access is already established. However, it is a lack of clarity of which is the best option in terms of efficacy and route of administration in the pre-hospital setting. The primary outcomes of this evidence synthesis are seizure cessation, time to seizure cessation from administration of study drug, recurrence of seizure and adverse events. Secondary outcomes include need for hospital admission, length of stay in intensive care, health related quality of life. Data from economic evaluations published in this clinical area will also be reviewed and summarised. This evidence synthesis will provide information on the optimal treatment to control seizures before arrival at the hospital and will inform future research.

For further information see:


Miriam Brazzelli;