Page "Status epilepticus" Paragraph 28

Today, the benzodiazepine of choice is lorazepam for initial treatment due to its relatively long ( 2 – 8 hr ) duration of action when injected, and its rapid onset of action, which is thought to be due to its high affinity for GABA receptors and to its low lipid solubility, which causes it to remain in the vascular compartment.

If lorazepam is not available, or intravenous access is not possible, then diazepam should be given.

Particularly in children, another increasingly popular treatment choice is buccal and intranasal midazolam, which can be given into the side of the mouth or the nose, respectively.

Sometimes, the failure of lorazepam alone is considered to be enough to classify a case of SE as refractory.