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Home use of rectal diazepam to prevent status epilepticus in children with convulsive disorders
C S Camfield1, P R Camfield, E Smith
1Department of Pediatrics, IW Killam Hospital for Children, Dalhousie University, Halifax, Nova Scotia, Canada.
Insights
Rectal diazepam effectively stops prolonged seizures at home for children. This treatment reduces hospitalizations and boosts parental confidence, though caution is advised for untrained administration.
Area of Science:
- Pediatric Neurology
- Emergency Medicine
Background:
- Prolonged seizures in children pose significant risks.
- Home-based seizure management is increasingly important for timely intervention.
- Rectal diazepam is a recognized option for acute seizure control.
Purpose of the Study:
- To evaluate the efficacy and safety of home administration of rectal liquid diazepam for children experiencing prolonged seizures.
- To assess the impact of home treatment on hospitalization rates and parental confidence.
Main Methods:
- Prospective study involving 30 families trained in administering rectal liquid diazepam.
- Children included had a history of prolonged afebrile or prolonged/repeated febrile seizures.
- Follow-up assessed administration success, complications, and need for hospitalization.
Main Results:
- 17 out of 30 families administered rectal diazepam an average of three times per child without complications.
- Prompt seizure cessation was reported by 15 of 17 families.
- Two cases required hospitalization due to unsuccessful rectal diazepam administration.
Conclusions:
- Rectal diazepam is a valuable adjunctive home treatment for children at risk of prolonged seizures.
- Home administration can decrease hospitalizations and enhance parental confidence in managing seizures.
- The potential for untrained individuals to administer rectal diazepam necessitates anticipation and guidance.
Abstract:
Thirty families were taught to administer rectal liquid diazepam to their children to stop a seizure at home. Twelve children had previous prolonged afebrile seizures, and 18 had either prolonged or repeated febrile seizures. During follow-up, 17 of the 30 families administered the rectal diazepam an average of three times per child with no complications. Fifteen of 17 families reported prompt cessation of the seizure, while in two the rectal diazepam was unsuccessful and hospital treatment was needed. We conclude that rectal diazepam is a useful adjunctive home treatment for children at risk for prolonged seizures. Hospitalization is decreased and parental confidence increased. Without our knowledge, twelve families taught others how to give the rectal diazepam, a practice that might be hazardous and should be anticipated.