Status epilepticus: recent experience at the Port of Spain General Hospital, Trinidad

In this retrospective study, experience in status epilepticus (SE) over an 18-month period at the Port-of-Spain General Hospital is reported. Sixty-three episodes in 41 patients were studied. Fifty-one per cent of patients were under 10 years of age. Fifty-one per cent of patients were classified as remote symptomatic, 29 per cent idiopathic, 15 per cent acute symptomatic and 5 per cent febrile. Bolus doses of diazepam were used in 62 of 63 episodes, phenytoin in 18, diazepam infusion in 9, paraldehyde in 12 and phenobarbitone in 9. Seizures were controlled within half-hour of starting treatment in 55 episodes (87 per cent). In 3 episodes in 2 patients (5 per cent), control was poor and exceeded 18 hours. No deaths were recorded. Two neurological deficits and 8 other morbid events were recorded. Mean hospital stay was 2.9 days. No patient was ventilated or admitted to the Intensive Care Unit. Current drug therapy is highly effective in SE even in institutions where modern intensive care technology is limited. Prognosis is excellent in patients whom the underlying aetiology is benign. (AU)

Intramuscular/oral lorazepam in acute alcohol withdrawal and incipient delirium tremens

Intra-muscular (5 Mg) lorazepam followed in 6 - 8 hours by 7 mg/day of oral lorazep-am averted delirium tremens and dissipated the severe symptoms of acute alcohol withdrawal in 21 patients. Symptoms subsided within 2 hours and remained under control (AU)