A Comparison of Buccal Midazolam and Intravenous Diazepam for the Acute Treatment of Seizures in Children

Overview

Journal Iran J Pediatr

Publisher Brieflands

Specialty Pediatrics

Date 2013 Feb 13

PMID 23399743

Citations 7

Authors

Seyed-Hassan Tonekaboni

Farhad Mahvelati Shamsabadi

Seyed-Saeed Anvari

Ali Mazrooei

Mohammad Ghofrani

Affiliations

Soon will be listed here.

Abstract

Objective: The purpose of the present study is to compare efficacy and safety of buccal midazolam with intravenous diazepam in control of seizures in Iranian children.

Methods: This is a randomized clinical trial. 92 patients with acute seizures, ranging from 6 months to 14 years were randomly assigned to receive either buccal midazolam (32 cases) or intravenous diazepam (60 cases) at the emergency department of a children's hospital. The primary outcome of this study was cessation of visible seizure activity within 5 minutes from administration of the first dosage. The second dosage was used in case the seizure remained uncontrolled 5 minutes after the first one.

Findings: In the midazolam group, 22 (68.8%) patients were relieved from seizures in 10 minutes. Meanwhile, diazepam controlled the episodes of 42 (70%) patients within 10 minutes. The difference was, however, not statistically significant (P=0.9). The mean time required to control the convulsive episodes after administration of medications was not statistically significant (P=0.09). No significant side effects were observed in either group. Nevertheless, the risk of respiratory failure in intravenous diazepam is greater than in buccal midazolam.

Conclusion: Buccal midazolam is as effective as and safer than intravenous diazepam in control of seizures.

Citing Articles

Benzodiazepines in the Management of Seizures and Status Epilepticus: A Review of Routes of Delivery, Pharmacokinetics, Efficacy, and Tolerability.

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PMID: 35971024 PMC: 9477921. DOI: 10.1007/s40263-022-00940-2.

Comparing the Sedative Effect of Oral and Intranasal Midazolam and their Effect on Behavior in Pediatric Dental Patients.

Kotian N, Subramanian E, Jeevanandan G Int J Clin Pediatr Dent. 2022; 15(1):128-134.

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Time Is Brain: Acute Control of Repetitive Seizures and Status Epilepticus Using Alternative Routes of Administration of Benzodiazepines.

Almohaish S, Sandler M, Brophy G J Clin Med. 2021; 10(8).

PMID: 33920722 PMC: 8073514. DOI: 10.3390/jcm10081754.

Drug management for acute tonic-clonic convulsions including convulsive status epilepticus in children.

McTague A, Martland T, Appleton R Cochrane Database Syst Rev. 2018; 1:CD001905.

PMID: 29320603 PMC: 6491279. DOI: 10.1002/14651858.CD001905.pub3.

Treatment of Generalized Convulsive Status Epilepticus in Pediatric Patients.

Alford E, Wheless J, Phelps S J Pediatr Pharmacol Ther. 2015; 20(4):260-89.

PMID: 26380568 PMC: 4557718. DOI: 10.5863/1551-6776-20.4.260.

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