Benzodiazepines are potent anticonvulsants that are commonly used intravenously and occasionally rectally to treat status epilepticus.23 Diazepam, midazolam, clonazepam, and lorazepam are all used as AEDs.48 Diazepam rectal gel is effective in controlling acute repetitive seizures (clusters). Intravenous midazolam drip may be more effective for refractory status than other benzodiazepines56 and may represent a substantial improvement over other therapeutic approaches, such as pentobarbital anesthesia.57

Paradoxically, diazepam may induce seizures in patients with Lennox-Gastaut syndrome and lower the seizure threshold in epilepsy patients receiving enflurane.58

Adapted from: Najjar S, Devinsky O, Rosenberg AD, et al. Procedures in epilepsy patients. In: Ettinger AB and Devinsky O, eds. Managing epilepsy and co-existing disorders. Boston: Butterworth-Heinemann; 2002;499–513. With permission from Elsevier (

Authored By: 
Orrin Devinsky MD
Souhel Najjar MD
Andrew D Rosenberg MD
Reviewed By: 
Steven C. Schachter MD
Wednesday, March 31, 2004