Table 4
Suggested approach to anticonvulsant treatment
| Indication for treatment | Loading | Maintenance |
|---|---|---|
| Seizure duration ⩾ 3 min or frequency ⩾ 3/hour | 1 Phenobarbitone 20 mg/kg (intravenously) | 6 mg/kg/d |
| Inadequate response: | 2 Repeat phenobarbitone further 10 mg/kg doses, up to a further 20 mg/kg (intravenously) | 6 mg/kg/d |
| lp;&-3q;1 | ||
| 3 Clonazepam 100-200 μg/kg (intravenously over 30 s) | ||
| 4 Clonazepam intravenous infusion 10-30 μg/kg/h | Once control achieved convert to daily dose | |
| 5 Phenytoin 20 mg/kg (intravenous rate < 1 mg/kg/m) | Not recommended | |
| Additional anticonvulsants | Paraldehyde 200-400 mg/kg (per rectum or intravenously) | 15-150 mg/kg/h intravenously (5% solution in 5% dextrose) |
| Sodium valproate 20 mg/kg (ORAL) | 10 mg/kg 12 hourly | |
| Consider pyridoxine dependency | Pyridoxine 100 mg (intravenously with EEG monitor) |
