The community use of rescue medication for prolonged epileptic seizures in children

Area of Science:

• Pediatric Neurology
• Pharmacology
• Public Health

Background:

• Prolonged seizures in children require effective rescue medication for community management.
• Assessing the real-world use, safety, and efficacy of these medications is crucial for improving patient care.
• The EPIC network aimed to gather data on rescue medication practices for children with epilepsy.

Purpose of the Study:

• To determine the prevalence, safety, and efficacy of various rescue medications for pediatric prolonged seizures in the community.
• To inform best practice guidelines for epilepsy management networks.

Main Methods:

• Clinician questionnaires collected data on prescribed rescue medications, epilepsy syndromes, and seizure types for children in the EPIC area.
• Carer questionnaires gathered information on their experiences and perceptions of using rescue medication.
• Data from 203 clinician and 190 carer questionnaires were analyzed.

Main Results:

• Buccal Midazolam was the most frequently prescribed rescue medication, followed by Rectal Diazepam and Paraldehyde.
• Over 80% of children had community care plans, and 90% of carers received administration training.
• A majority of carers (73%) found Buccal Midazolam and Rectal Diazepam effective in preventing hospital admissions.

Conclusions:

• Buccal Midazolam is the most commonly prescribed rescue medication by EPIC epilepsy pediatricians.
• Families reported Buccal Midazolam as the safest and most effective option for terminating seizures.
• Rescue medications significantly benefit children with severe epilepsy by reducing hospital admissions for prolonged seizures.