Status epilepticus: 30 mg rectal diazepam was effective in preventing further seizures

Clinical bottom line (level 1b)

  1. More patients in status epilepticus who had 30 mg of diazepam pr compared with 20 mg stopped fitting (NNT = 2 at 24 hours)
Remy et al: Epilepsia 1992; 33 (2): 353-358
Expires September 2003

The study

Unblinded ?concealed randomised trial without intention-to-treat
Setting: Specialist epilepsy centre

39 patients (aged mean age 31 ± 8, 35% female)
  • simple or complex partial seizures in a series of at least 20 minutes
  • two generalised tonic-clonic seizures in 20 minutes


Excluded if
  • GI, renal or cardiac disorder
  • body weight-height discrepancy


    • Control Group: (n = 21, 21 analysed): 20 mg intrarectal diazepam
    Experimental Group: (n = 18, 18 analysed): 30 mg intrarectal diazepam

    100% followed for 24 hours stopping repeated seizures

    The evidence

    Outcome Time to outcome CEREERRRR
    (95% CI)    		ARR
    (95% CI)    		NNT
    (95% CI)
    Seizure stopped minutes 6
    (28.8%)    		 13
    (72.2%)    		 61.0%
    (14% to 82%)    		 43.7%
    (15.3% to 72.0%)    		 2
    (1 to 7)

    Outcome Control Group
    (SD)    		 Experimental Group
    (SD)    		 Mean Difference
    (95% CI)
    Total to end of convulsion in minutes 7.5
    (5)     		11.2
    (9.1)     		3.7
    (-0.98 to 8.38)

    Citation

    1. Remy C, Jourdil N, Villemain D, et al: Intrarectal Diazepam in Epileptic Adults. Epilepsia 1992; 33 (2): 353-358
    Contributor: Christopher Ball and Musab Hayatli, Unknown Month 2000
    Reviewer:

    Clinical Question.
    Patient status epilepticus
    Intervention or Exposure pr diazepam, 20 mg
    Comparison pr diazepam, 30mg
    Outcome cessation of seizure