Paraldehyde toxicity during treatment of status epilepticus

B. Bostrom

A 2-month-old girl survived a lethal serum level of paraldehyde after being given the drug intravenously (IV) for status epilepticus. On the basis of known pharmacokinetic data in man, a slow IV infusion, over a period of five minutes, of 200 mg/kg of paraldehyde followed by a drip of 20 mg/kg/hr should result in safe, rapid control of status epilepticus when first-line anticonvulsant drugs have failed. The paraldehyde should be diluted to a 10% solution with 5% dextrose water.