Post-Quiz: Status Epilepticus Neuro 111

A 47-year-old female with a known history of myasthenia gravis is brought to the emergency department exhibiting severe muscle weakness, difficulty with swallowing, and extreme shortness of breath. Lab results and her clinical presentation confirm that she is having a myasthenic crisis. Which medication from the following list is least likely to exacerbate her condition?

A 16-year-old female patient with a known history of epilepsy presents to the emergency department in a state of continuous seizure activity, classified as status epilepticus. She is not currently taking any anti-epileptic drugs. Her weight is documented to be 50 kg (converted from the initial 110 pounds). Recognizing the urgent need for seizure control, you decide to administer levetiracetam. What is the most appropriate dosage to provide her with?

An adult male patient, aged 31 years, who is an established patient with a seizure disorder, is brought into the hospital following a seizure incident at home. The patient, whose typical anti-seizure medication regimen includes phenytoin and lacosamide, received an intramuscular dose of 10 mg midazolam before arriving at the hospital. Despite this measure, he has not returned to his normal state and shows continued subtle twitching in the face and extremities. The patient’s weight is 100 kg and he is clinically stable, with vital signs currently at: blood pressure 134/91 mmHg, heart rate 94 bpm, respiratory rate 14 breaths/min, and oxygen saturation 98% on room air. A peripheral IV has been established. Given his current state, which treatment option would likely offer the most therapeutic benefit?

RL is a 47-year-old male with a history of epilepsy. He is brought to the Emergency Department (ED) via Emergency Medical Services (EMS) following a series of seizures. A 20-gauge peripheral IV was inserted by the EMS and RL received 4 mg of lorazepam IV en route. His weight is 75 kg. Upon arrival to the ED, RL continues to endure tonic-clonic seizures, which he has been experiencing for the past ten minutes with no return to baseline clinical status.

Based on the provided information and clinical presentation, which of the following would be the most appropriate urgent control therapy for RL’s seizures?

A 43-year-old female patient with a medical history of breakthrough seizures presents to the ED after experiencing a seizure at home. Her phenytoin level was found to be undetectable. The emergency team initiated management with intravenous fosphenytoin. What is the maximum recommended infusion rate for fosphenytoin?