acute

Seizure (Convulsion)

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources2 sources

Egyptian National Drug Formulary - nervous-2025.pdf, Diazepam monograph (chapter PDF p21) · Lovik K, Murr NI. Seizure. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-.

Verified against2 documents

Egyptian National Drug Formulary - nervous-2025.pdf, Diazepam monograph (chapter PDF p21)
Lovik K, Murr NI. Seizure. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-.

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (10)

Sudden loss of awareness with limb movement is how a convulsion is usually described [seizures]
A generalised fit stiffens first and then jerks rhythmically [seizures]
It may begin with a sound or a cry, and some feel a warning or aura first
Wetting is inconstant, so dry clothing rules nothing out [urinary incontinence]
When the tongue is bitten, the bite is usually along its side
Awareness stays altered afterwards, in what is called the postictal state
Brief altered awareness, odd behaviour or a strange perception can equally be a fit [seizures]
The dyscognitive or complex partial kind changes awareness rather than causing a convulsion
It can look like nothing but confusion, with at most lip-smacking or a small movement of a limb [confusion]
In adults the commonest type starts in one area and then spreads fast to the whole cortex

Signs — what you find (6)

A witness may report open eyes, no response to voice or pain, and rhythmic movements in step
Examine generally and neurologically, hunting for a focal deficit
Red flag: awareness that does not return after a suspected fit raises transformed status epilepticus [seizures · status epilepticus]
Subtle status may show only flickering eyes, facial twitching, limb twitches, or nothing moving
Red flag: status epilepticus is one generalised convulsion past 5 minutes, or a run of them with no full recovery in between [seizures · status epilepticus]
Red flag: the generalised convulsive form of it is an emergency

Tests (12)

Start by asking the carer whether this was a fit at all, or another kind of passing episode
Once it is a fit, decide next whether something provoked it
Ask about earlier fits, medicines, alcohol and illicit drugs, and about low immunity or cancer
Past unresponsive spells may in hindsight have been fits
What happened just beforehand matters, and friends, family or workmates may hold that account
Where epilepsy is already known, ask straight away about missed or erratic doses
Bloods including electrolytes are the usual first tests
Consider lumbar puncture with fever, low immunity, or anything else pointing to brain infection
Brain imaging pays off most when the history or a focal neurological sign points that way
Image after head trauma, cancer, low immunity, fever, lasting headache, anticoagulants, age older than 40 years, or focal onset
After a first fit in an adult back to baseline, check serum glucose and sodium, and pregnancy where relevant
EEG is the marker, and focal or generalised epileptiform discharges are its hallmark

If not this — what else fits (9)

Fainting is the main rival, and both begin abruptly
A faint tends to have a trigger, a short blackout, and waking without a confused spell
Wetting happens in either, so it does not separate them
A faint can carry jerking that imitates a fit
Psychogenic non-epileptic seizures
Convulsive concussion
A movement disorder, or movements arising out of sleep
Rigors and convulsive syncope belong on the same list as fainting and the psychogenic attacks
Epilepsy means repeated fits with nothing provoking them, so provoked or not is the question that decides both diagnosis and treatment

SourceStatPearls "Seizure" - disease-level clinical article

Presentation findings are traced to the source above.

DIAZEPAM

1st line

Forminjection

Adult dose and duration

5-10 mg IV (preferred) or IM initially by slow injection; may repeat every 10-15 minutes if needed up to a maximum of 30 mg; if necessary repeat again after 2-4 hours, with caution in chronic lung disease or unstable cardiovascular status. - Single acute treatment episode for an ongoing seizure/status epilepticus; not for regular daily use.

Paediatric dose

Paediatric status-epilepticus dosing (including rectal/buccal routes) is specialist-set and is not reproduced here; arrange urgent transfer for any convulsing child.

Dose source

Egyptian National Drug Formulary - nervous-2025.pdf, Diazepam monograph (chapter PDF p21)

Why

Diazepam is the first-line benzodiazepine for terminating an acute seizure or status epilepticus while arrangements are made for urgent transfer/referral.

Cautions

Given by injection, not by mouth: the dose is the IV/IM status-epilepticus line.
Diazepam is only for terminating an active seizure or status epilepticus - it is not a maintenance anticonvulsant.
There is a risk of respiratory depression, especially given IV or with other sedatives - have resuscitation support available.
A seizure lasting several minutes, or repeated seizures without recovery between them, is status epilepticus - a medical emergency needing urgent transfer.
Fever with seizure and neck stiffness suggests meningitis/encephalitis - treat and refer urgently.
A first seizure in an adult needs urgent work-up for a structural or metabolic cause once terminated.
Seizure in pregnancy with high blood pressure suggests eclampsia - manage as an obstetric emergency.
Maintenance antiepileptics (levetiracetam, carbamazepine, lamotrigine, valproate) do NOT stop an active seizure and are not on this page. They are under Epilepsy (continuing therapy), which is where a repeat prescription belongs.

Egyptian brands

Egyptian brand	Manufacturer	Indicative price
VALPAM 5 MG/ML 3 AMP.	AMOUN	6.00 EGP
EPIVAL 10MG/2ML 3 AMP.	EIPICO	15.00 EGP
NEURIL 10MG/2ML 5 AMP.	MEMPHIS	40.00 EGP

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.