Background Antiepileptics including benzodiazepines have long been recogniz
ed to provoke seizures and precipitate status epilepticus occasionally. Thi
s 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 t
o highlight the clinical importance of such a situation.
Methods. The clinical course of a 28-year old man with complex partial stat
us, 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 contrib
uted in exacerbating and prolonging the duration of status.
Conclusion. Paradoxic response to diazepam and midazolam is rare, but may b
e underrecognized. It should be considered in the setting of refractory sta
tus epilepticus. (C) 2000 IMSS. Published by Elsevier Science Inc.