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Treatment:

First aid measurements:

Suction, head position, O 2.

Rectal diazepam 0.3-0.5 mg/kg ( 1mg/min ) maximum 10 mg

If there is IV access: IV diazepam 0.3 mg/kg ( 1mg/min ) maximum 10 mg

Repeat a second dose of diazepam if convulsions recur or if no response in 10

minutes. If no response start continuous diazepam IV infusion (2-3 mg

/kg/hr).

-If no response to diazepam after the first dose try the following in order:

IV phenytoin: loading 15 mg /kg over 30 min followed by 12 hrs latter by

maintenance dose 3 mg/kg/12hr

IV Phenobarbital: loading 20 mg /kg over 30 min followed by 12 hrs latter by

maintenance dose 5 mg/kg/24hr

N.B. Take care of incidence of respiratory depression if given after diazepam

For refractory cases: induce general anesthesia

Thiopental IV, intubation , muscle relaxants and artificial respiration

→ convulsions monitored by continuous EEG monitoring

Search for the cause: treatment specially for electrolyte dsturbances