🏥 USMLE Exam Prep

A 10-year-old boy is brought to the emergency department after a prolonged generalized tonic-clonic seizure lasting over 10 minutes. He is still seizing despite the administration of intravenous lorazepam. What is the most appropriate next step in managing his status epilepticus?

A Administer another dose of lorazepam
B Initiate continuous electroencephalography (EEG) monitoring
C Administer intravenous fosphenytoin or levetiracetam
D Prepare for emergent intubation and mechanical ventilation

✓ Correct Answer: Option C

After initial benzodiazepine failure in status epilepticus, a second-line antiepileptic drug like fosphenytoin, levetiracetam, or valproate should be administered to achieve seizure control. Repeat benzodiazepines are generally less effective after initial failure.

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