Convulsive status epilepticus (CSE) is a neurological emergency in adults and children. However, whether
a particular benzodiazepine is of superior efficacy and safety in management of CSE is controversial. We
performed a meta-analysis to compare the outcome of lorazepam and diazepam for treating CSE. We
searched the PubMed, Medline, Embase, Cochrane Central Register of Controlled Trials, and Google
Scholar databases from 1966 to February 2014. No language restriction was applied. Reference lists of
all the selected articles were hand-searched for any additional trials. Trial quality was assessed using
the modified Jadad scale and the Consolidated Standards Of Reporting Trials (CONSORT) checklist. Two
authors independently extracted data from all eligible studies, including study design, participants, interventions,
and outcomes. The data was analyzed using fixed-effects or random-effects models with mean
differences and risk ratios for continuous and dichotomous variables, respectively. A total of six studies
involving 970 patients were included in this analysis. The majority of patients were children (n = 574)
and 396 patients were adults. Meta-analysis showed no significant difference between the two treatment
groups regarding seizure control and adverse effects regardless of patient age. This meta-analysis demonstrates
that diazepam and lorazepam have equal efficacy and side effects for treating CSE in adults and
children, and either can be chosen as a reasonable first-line therapy. More high quality randomized controlled
trials are needed to support this finding.
Convulsive status epilepticus (CSE) is a neurological emergency in adults and children. However, whethera particular benzodiazepine is of superior efficacy and safety in management of CSE is controversial. Weperformed a meta-analysis to compare the outcome of lorazepam and diazepam for treating CSE. Wesearched the PubMed, Medline, Embase, Cochrane Central Register of Controlled Trials, and GoogleScholar databases from 1966 to February 2014. No language restriction was applied. Reference lists ofall the selected articles were hand-searched for any additional trials. Trial quality was assessed usingthe modified Jadad scale and the Consolidated Standards Of Reporting Trials (CONSORT) checklist. Twoauthors independently extracted data from all eligible studies, including study design, participants, interventions,and outcomes. The data was analyzed using fixed-effects or random-effects models with meandifferences and risk ratios for continuous and dichotomous variables, respectively. A total of six studiesinvolving 970 patients were included in this analysis. The majority of patients were children (n = 574)and 396 patients were adults. Meta-analysis showed no significant difference between the two treatmentgroups regarding seizure control and adverse effects regardless of patient age. This meta-analysis demonstratesthat diazepam and lorazepam have equal efficacy and side effects for treating CSE in adults andchildren, and either can be chosen as a reasonable first-line therapy. More high quality randomized controlledtrials are needed to support this finding.
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