رجل عمره ٤٤ سنة، يشرب الكحول، وُجد في الجناح في نوبة تشنج مستمرة منذ ٦ دقائق ولم يصحُ بين النوبات. التشبع ٨٩٪ على قناع، والسكر ٩٦، وعنده كانيولا في يده. ما الدواء الأول المتوقع؟

A 44-year-old man who drinks alcohol is found on the ward seizing continuously for 6 minutes without recovery between seizures. SpO2 89% on a mask, glucose 96 mg/dL, and he has a cannula in his hand. Which drug is expected first?

1. Intramuscular haloperidol
2. Oral phenytoin
3. IV lorazepam
4. IV paracetamol

Answer: C) IV lorazepam. Seizures over 5 minutes or repeated without recovery are status epilepticus. First line is a benzodiazepine (IV lorazepam, or IM midazolam without access), then a second agent such as levetiracetam or phenytoin.