Paradoxic response to diazepam in complex partial status epilepticus.
BACKGROUND
Antiepileptics including benzodiazepines have long been recognized to provoke seizures and precipitate status epilepticus occasionally. This has a special clinical importance in the case of diazepam because of its use as first choice medication in its management. This report is intended to highlight the clinical importance of such a situation.


METHODS
The clinical course of a 28-year old man with complex partial status, which lasted for two months, is described in detail.


RESULTS
Paradoxic response to diazepam was documented under EEG monitoring. A similar response was also noted for midazolam, and had probably contributed in exacerbating and prolonging the duration of status.


CONCLUSIONS
Paradoxic response to diazepam and midazolam is rare, but may be under-recognized. It should be considered in the setting of refractory status epilepticus.
Al Tahan
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A
Division of Neurology, College of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.
D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects*; D003975:Diazepam / Q000009:adverse effects*; D004569:Electroencephalography; D017036:Epilepsia Partialis Continua / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008874:Midazolam / Q000009:adverse effects
D000927:Anticonvulsants; D003975:Diazepam; D008874:Midazolam