Anticonvulsants nerve agent exposure

Convulsions occur after severe nerve agent exposure. In reports18,63,81 of severe cases, convulsions (or what were described as convulsive jerks or spasms ) started within seconds after the casualty collapsed and lost consciousness, and persisted for several minutes until the individual became apneic and flaccid. The convulsions did not recur after atropine and oxime therapy and ventilatory support were administered. In these instances, no specific anticonvulsive therapy was needed nor was it given. 

Victims of certain chemical exposures will experience seizure activity. Patients must be protected from harm. Benzodiazepines are the mainstays in seizure treatment. Liberal doses are required titrate to effect. Termination of seizure activity may reflect onset of flaccid paralysis from the nerve agent rather than adequacy of anticonvulsant therapy. A bedside electroencephalograph (EEG) may be required to assess ongoing seizure activity. 

Post-Exposure Therapy. The main principles of therapy for nerve agent poisoning are early treatment, assisted ventilation, bronchial suction, muscarinic cholinergic blockade (atropine), enzyme reactivation (2 Pam Chloride) and anticonvulsants (Diazepam). GD permanently binds to receptors in two minutes after that 2 PAM Cl is not useful. 

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