Seizures in palliative care

I read this article with interest. I was interested to learn of the risks of phenobarbital (respiratory failure) vrs phenytoin in mgmt of status epilepticus. My 1st line is always lorazepam, as discussed, and have used midazolam (in lower than described doses, eg. 3-5mg instead of 10mg), and have always had settling of seizures with these measures, unless it is a terminal event. As stated in the article, even if a terminal event, the use of benzodiazepines in this circumstance can still provide comfort, and symptom control to the end of life. Midazolam infusions can be used (as for terminal sedation), for seizure mgmt, when refractory, and at the end of life.

Conflict of Interest:

None declared