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Intranasal midazolam for prolonged convulsive seizures
N O Kutlu1, C Yakinci, M Dogrul
1Department of Pediatrics, Inonu University, Turgut Ozal Medical Center, Malatya, Turkey. onurkutlu@hotmail.com
Insights
Intranasal midazolam effectively treated prolonged seizures in children, achieving a 100% success rate. This study highlights its rapid action and safety for pediatric convulsive episodes.
Area of Science:
- Pediatric Neurology
- Emergency Medicine
- Pharmacology
Background:
- Prolonged convulsive episodes in children pose significant medical challenges.
- Rapid and effective interventions are crucial for managing pediatric seizures.
- Intranasal administration offers a non-invasive route for emergency medication delivery.
Purpose of the Study:
- To evaluate the efficacy and safety of intranasal midazolam for treating prolonged convulsive seizures in pediatric patients.
- To determine the time to seizure cessation and overall success rate of intranasal midazolam.
Main Methods:
- A prospective study involving nine pediatric patients (6 months to 9 years) with seizures lasting over 10 minutes.
- Treatment administered: intranasal midazolam at a dose of 0.3 mg/kg.
- Data collected on seizure duration, time to cessation, and adverse events.
Main Results:
- 100% success rate in terminating prolonged seizures with intranasal midazolam.
- Mean seizure duration was 18.6 minutes; mean time to cessation was 139.6 seconds.
- Only one patient required a second dose; no significant adverse effects reported besides transient respiratory depression in a critically ill child.
Conclusions:
- Intranasal midazolam is a highly effective and rapid-acting treatment for prolonged convulsive seizures in children.
- The 100% success rate supports its use as a first-line emergency treatment.
- Minimal adverse effects suggest a favorable safety profile for this administration route.
Abstract:
In order to determine the efficiency of intranasal midazolam in prolonged convulsive episodes, we conducted a prospective study in children with various types of seizures. Nine patients (six boys, three girls; age range 6 months to 9 years) with prolonged convulsions lasting more than 10 min were treated with intranasal midazolam, 0.3 mg/kg. The success rate was 100% with only one case requiring a second dose. Estimated duration of seizures was 12-30 min (mean 18.6) while mean time elapsed until cessation of seizures was 139.6 s (range 60-480). No significant adverse effects were noted except for one patient who had seizures secondary to serious CNS infection and respiratory depression after intranasal midazolam.