Rescue Medication for Prolonged Seizures

The vast majority (> 90%) of epileptic seizures stop spontaneously within a few minutes and do not require special interventions or acute medication. Epilepsy is treated primarily with long-term antiseizure medication aimed at preventing seizures. Treatment is adjusted if seizures occur despite regular medication.

For prolonged seizures, rescue medication is used. If a person is prone to prolonged seizures, rescue medication may be prescribed for home use. The treating physician prescribes the medication, provides written individualized instructions for its use, and—together with a nurse—trains the person or caregivers in correct administration and post-administration monitoring.

Rescue medications include buccal midazolam solution or rectal diazepam. Rescue medication is usually administered by a family member or staff in a daycare center, school, or residential care facility; the person administering the medication does not need to be a healthcare professional. However, they must be competent in the administration technique and know when the person’s seizure is unusually prolonged or likely to recur and therefore requires rescue medication.

If the seizure continues despite administration of rescue medication, the emergency number 112 must be called and the person taken to hospital for further treatment.

If a person’s epilepsy is well controlled or they have been seizure-free, rescue medication does not usually need to be prescribed. If a person with previously well-controlled epilepsy unexpectedly has a seizure, it is important to contact the treating clinic or seek urgent medical care as needed to receive guidance on possible adjustments to long-term medication.