Efficacy of Intravenous Midazolam for Status Epilepticus in Childhood

Hayashi, Kitami; Ōsawa, Makiko; Aihara, Masao; Izumi, Tatsuro; Ohtsuka, Yoko; Haginoya, Kazuhiro; Kato, Ikuko; Kaneko, Kenitiro; Sugai, Kenji; Takahashi, Tsuyoshi; Hamano, Shin ichiro; Matsukura, Makoto; Miura, Hisao; Minagawa, Kimio; Yamano, Tsunekazu; Yamamoto, Hitoshi; Yamanouchi, Hideo; Yoshikawa, Hideto

doi:10.1016/j.pediatrneurol.2007.02.012

Cited by 71 publications

(50 citation statements)

References 19 publications

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“…[2][3][4] Our results are comparable to those reported in the literature assessing the use of midazolam for seizure control in the emergency setting and reporting success rates of 56 to 96.7%. 3,5,8,10,11,[13][14][15][16][17] To our knowledge, there are no studies comparing IV midazolam to either lorazepam or diazepam IV in the ED setting. Silbergleit and colleagues published a double-blind, randomized, noninferiority trial comparing the efficacy of IM midazolam to that of IV lorazepam: IM midazolam was at least as safe and effective as IV lorazepam.…”

Section: Discussionmentioning

confidence: 99%

“…12 Multiple studies have proven that midazolam is at least as effective as diazepam in terms of safety and risk of recurrence, with the advantage of providing a faster initiation of treatment, leading to more rapid seizure cessation. 3,5,8,10,11,[13][14][15][16][17][18][19] Midazolam has emerged as a highly efficacious drug in the treatment of impending SE, with several routes of administration exhibiting high bioavailability. 19 In a recent article proposing evidence-based and expert consensus practice guidelines, the Neurocritical Care Society lists midazolam as Class I, Level A for the emergent treatment of SE, as Class IIB, Level B for urgent treatment (continuous infusion), and as Class IIa, Level B for refractory treatment using the evidence rating system of the American Heart Association. )…”

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confidence: 99%

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Quality assurance evaluation of a simple linear protocol for the treatment of impending status epilepticus in a pediatric emergency department 2 years postimplementation

Tourigny-Ruel

Diksic

Mok

et al. 2014

CJEM

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Objective: To evaluate the efficacy and safety of a simple linear midazolam-based protocol for the management of impending status epilepticus in children up to 18 years of age. Methods: This is a descriptive, quality assessment, retrospective chart review of children presenting with the chief complaint of seizure disorder in the emergency department (ED) of a tertiary care pediatric hospital and a triage category of resuscitation or urgent from April 1, 2009, to August 31, 2011 In children with at least one seizure episode in the ED treated according to the linear protocol, three main outcomes were assessed: compliance, effectiveness, and complications. Results: Of the 128 children meeting the above study criteria, 68 had at least one seizure episode in the ED, and treatment was required to terminate at least one seizure episode in 46 of 68 patients (67.6%). Fifty-five seizure episodes were treated in the 46 patients: 51 of 55 seizure episodes were treated with midazolam (92.7%) and 4 of 55 with lorazepam or diazepam (7.3%). Of those treated with midazolam, 86.3% (44 of 51) were successfully treated with one or two doses of midazolam. The median seizure duration for all treated patients was 6 minutes. Of the 42 patients treated with midazolam, 7 required either continuous positive airway pressure or intubation, and two patients were treated for hypotension. One patient died of pneumococcal meningitis. Conclusion: This simple linear protocol is an effective and safe regimen for the treatment of impending status epilepticus in children. RÉ SUMÉObjectif: L'é tude visait à é valuer l'efficacité et l'innocuité d'un simple protocole liné aire, fondé sur le midazolam, pour le traitement d'un é tat de mal é pileptique imminent, chez des enfants â gé s de 18 ans et moins.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Quality assurance evaluation of a simple linear protocol for the treatment of impending status epilepticus in a pediatric emergency department 2 years postimplementation

Tourigny-Ruel

Diksic

Mok

et al. 2014

CJEM

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“…Intravenous midazolam infusion has been shown to be effective in the most worrisome patients, those with refractory status epilepticus unresponsive to the usual anticonvulsants (diazepam, lorazepam, phenytoin, and phenobarbital) (8,(10)(11)(12)(13). Midazolam as a single dose, or as an infusion, is able to stop refractory status epilepticus effectively (8,(10)(11)(12)(13). If midazolam is proposed as the medication to use after all others have failed, it would seem logical that it could be a good choice as a first line agent as long as there are no adverse side effects to its use.…”

Section: Drug Management For Acute Tonic-clonic Convulsions Includingmentioning

confidence: 99%

Commentary on ‘Drug management for acute tonic‐clonic convulsions including convulsive status epilepticus in children’, with a response from the review authors

McGillivray

Dayan

Pusic

et al. 2009

Evid.‐Based Child Health

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This is a commentary on a Cochrane review, published in this issue of EBCH, first published as: Appleton R, Macleod S, Martland T. Drug management for acute tonic‐clonic convulsions including convulsive status epilepticus in children. Cochrane Database of Systematic Reviews 2008, Issue 3. Art. No.: CD001905. DOI: 10.1002/14651858.CD001905.pub2.Further information for this Cochrane review is available in this issue of EBCH in the accompanying Summary article. Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. The Cochrane Collaboration

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“…Midazolam also has a short duration of action (and a short elimination half-life) [37], as illustrated in the study by Hayashi et al [37] in Japan. After a single intravenous (IV) administration of midazolam, 56.6% of the seizures could be stopped but 119 out of 162 patients nevertheless required continuous IV infusion to fully control the continuing or relapsing seizures [20].…”

Section: Acute Treatment Optionsmentioning

confidence: 99%

Clinical practice

Lagae

2011

Eur J Pediatr

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An adequate early treatment of a long-lasting convulsive seizure is critical in reducing potential morbidity, and in particular, brain damage. In pre-hospital settings the use of benzodiazepines should become standard. Nowadays, rectal diazepam is used frequently, but midazoloam and lorazepam are becoming more popular, both being given either intranasally or orally. The buccal route is to be preferred because of its easy use and high efficacy. A generally accepted policy for early treatment of convulsive seizures is a crucial issue in the elaboration of an overall treatment plan for the child with epilepsy. Such a plan should include instruction and education of the parents and the caregivers surrounding the child.

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Efficacy of Intravenous Midazolam for Status Epilepticus in Childhood

Cited by 71 publications

References 19 publications

Quality assurance evaluation of a simple linear protocol for the treatment of impending status epilepticus in a pediatric emergency department 2 years postimplementation

Quality assurance evaluation of a simple linear protocol for the treatment of impending status epilepticus in a pediatric emergency department 2 years postimplementation

Commentary on ‘Drug management for acute tonic‐clonic convulsions including convulsive status epilepticus in children’, with a response from the review authors

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