Which anti-epileptic drug is the long-term drug of choice for convulsive status epilepticus?

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The key idea is that after the seizures are acutely stopped, you need a maintenance antiseizure to prevent recurrence in convulsive status epilepticus. Phenytoin fits this role well because it blocks voltage-gated sodium channels, stabilizing neuronal membranes and reducing the likelihood of ongoing, repetitive firing. It has long been used as a maintenance agent in status epilepticus and can be given intravenously (as fosphenytoin) for inpatient control and then transitioned to oral dosing for long-term prevention. While it requires monitoring due to nonlinear metabolism and potential drug interactions, it provides durable, ongoing seizure control, which is why it is considered the long-term choice. Diazepam is excellent for rapid termination but not ideal for maintenance because tolerance and sedative effects limit its long-term use; valproate and levetiracetam are valid alternatives in some scenarios, but phenytoin has the traditional role as the maintenance drug.