Literature Monitor

Benzodiazepines Underutilized in Seizure Clusters

Seizure; ePub 2018 May 21; Jafarpour et al.


Patients with epilepsy clusters can benefit from rescue medications, but these drugs are underutilized according to a recent review of the medical literature.

  • Saba Jafarpour from Boston Children’s Hospital, and associates found that the definition of epilepsy clusters differs among experts, including 3 or more seizures in 24 hours, 2 or more in 24 hours, and 2 or more in 6 hours.
  • Most of the research analyzed by the investigators was conducted at tertiary centers on patients with refractory epilepsy.
  • Although rectal diazepam gel is the only medication approved by the FDA as a rescue drug for seizure clusters, the researchers found that non-rectal oral benzodiazepines are effective and safe for outpatient treatment of these clusters.
  • Acute treatment of seizure clusters can help prevent status epilepticus and reduce emergency department visits.

Jafarpour S, Hirsch LJ, Gaínza-Lein M, Kellinghaus C, Detyniecki K. Seizure cluster: definition, prevalence, consequences, and management [Published online ahead of print May 21,2018]. Seizure. DOI:

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