Use of clobazam in certain forms of status epilepticus and in startle-induced epileptic seizures.

Sixteen patients with status epilepticus (SE) and 13 patients suffering from startle-induced epilepsy were treated with clobazam (CLB). Status epilepticus was of the absence (six cases), myoclonic-absence (one case) myoclonic (one case), tonic (one case), and single or complex partial (seven cases) type. In all patients, consciousness was sufficiently retained during SE to allow CLB ingestion. Clobazam was administered in a single oral dose (0.5 to 1.70 mg/kg, mean 1.08 mg/kg) under electroencephalographic monitoring. In all patients but one, SE terminated within 15 to 31 min (mean 24.4 min) after CLB administration without significant side effects. Treatment of SE depends on the clinical context and type of SE. We conclude that CLB is a useful drug in the management of some forms of SE. In 13 patients suffering from startle-induced epileptic seizures, CLB was added to the previous ineffective treatment protocol. Of these 13 patients, 15.4% were completely unresponsive, 23.1% experienced drug resistance, and 61.5% achieved a good control (91.5% reduction of the reflex seizures) for a mean of 22.7 months. Drowsiness was observed in four patients, whereas favorable side-effects were observed in four patients.