[A control study on the treatment of acute seizures with midazolam and diazepam in children]

Area of Science:

• Pediatric Neurology
• Emergency Medicine
• Clinical Pharmacology

Background:

• Acute seizures in children are a common pediatric emergency requiring prompt treatment.
• Benzodiazepines, such as midazolam and diazepam, are first-line agents for seizure termination.

Purpose of the Study:

• To compare the efficacy and safety of midazolam versus diazepam in treating acute seizures in pediatric patients.
• To evaluate the effectiveness of these agents in managing recurrent seizures or status epilepticus.

Main Methods:

• A randomized controlled trial involving 120 children with acute seizures.
• Patients were assigned to receive either midazolam (0.1-0.3 mg/kg) or diazepam (0.3-0.5 mg/kg).
• Maintenance doses and adjunctive treatments were administered as needed, with therapeutic effects compared between groups.

Main Results:

• Both midazolam and diazepam achieved seizure relief in all patients within 10 minutes of initial administration.
• Midazolam demonstrated a significantly lower rate of seizure recurrence or status epilepticus (5 vs. 13 children, P<0.05).
• The average time to seizure control after maintenance treatment was significantly shorter with midazolam (40±32 min) compared to diazepam (69±24 min, P<0.05). No treatment-related adverse events were observed.

Conclusions:

• Midazolam is a safe and effective option for the treatment of acute seizures in children.
• Midazolam appears to be superior to diazepam in managing recurrent seizures or status epilepticus due to a lower recurrence rate and faster seizure control.