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. Conclusion. Paradoxic response to diazepam and midazolam is rare, but may be underrecognized. It should be considered in the setting of refractory status epilepticus. (C) 2000 IMSS. Published by Elsevier Science Inc.