Related Experiment Video

Updated: Mar 5, 2026

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
06:59

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings

Published on: November 9, 2016

31.4K

Buccal Midazolam Compared With Rectal Diazepam Reduces Seizure Duration in Children in the Outpatient Setting

Raffaella Moretti1,2,3,4, Sebastien Julliand5, Victoria Elisa Rinaldi1

  • 1From the Pediatric Emergency Department.

Pediatric Emergency Care
|March 29, 2017
PubMed

Insights

Buccal midazolam significantly reduced seizure duration and the risk of status epilepticus in children compared to rectal diazepam. This study highlights its advantages for outpatient seizure management by caregivers.

Area of Science:

  • Pediatric Emergency Medicine
  • Neuroscience
  • Pharmacology

Background:

  • Pediatric seizures are common and often managed by untrained caregivers in outpatient settings.
  • Benzodiazepines, particularly diazepam, are the historical first-line treatment for acute seizures.
  • Emerging research explores alternative benzodiazepines for pediatric seizure management.

Purpose of the Study:

  • To assess caregiver management of pediatric seizures in an outpatient environment.
  • To compare rectal diazepam with buccal midazolam for immediate seizure management and outcomes.
  • To identify differences in seizure characteristics and treatment efficacy between the two administration routes.

Main Methods:

  • Retrospective analysis of 594 pediatric seizure cases at a French pediatric emergency department over 18 months.
  • Evaluation of seizure characteristics, caregiver interventions, and treatment administered.
  • Focus on 135 children with subsequent seizure episodes for detailed comparison.

Main Results:

  • Buccal midazolam use was associated with significantly shorter seizure durations (10.3 vs. 48.4 minutes) compared to rectal diazepam.
  • The risk of developing status epilepticus was notably lower with buccal midazolam (1 vs. 11 cases).
  • No significant difference in hospital admission rates was observed between the two treatment groups.

Conclusions:

  • Buccal midazolam demonstrates advantages over rectal diazepam for outpatient pediatric seizure management.
  • Improved feasibility and reduced seizure duration are key benefits of buccal midazolam.
  • Further research may support buccal midazolam as a preferred rescue therapy for pediatric seizures.
Abstract

More Related Videos

Behavioral Characterization of Pentylenetetrazole-induced Seizures: Moving Beyond the Racine Scale07:35

Behavioral Characterization of Pentylenetetrazole-induced Seizures: Moving Beyond the Racine Scale

Published on: July 8, 2025

1.5K
Implantation of Electroencephalogram and Electrocardiogram Telemetry Devices in Neonatal Rabbit Kits06:46

Implantation of Electroencephalogram and Electrocardiogram Telemetry Devices in Neonatal Rabbit Kits

Published on: February 28, 2025

880

Related Concept Videos

Drug Delivery: Enteral Route01:18

Drug Delivery: Enteral Route

The enteral drug administration involves three primary routes: oral, sublingual, and buccal. Oral ingestion is the most prevalent, safe, economical, and convenient method for drug administration. However, it has certain drawbacks, including limited absorption due to the drug's low water solubility or poor membrane permeability, possible emesis from GI mucosa irritation, destruction of drugs by digestive enzymes or low gastric pH, and irregular absorption along with food or other drugs.
2.2K
Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
844
Anxiolytic Drugs: Benzodiazepines and Buspirone01:29

Anxiolytic Drugs: Benzodiazepines and Buspirone

Benzodiazepines are a class of anxiolytic drugs known for their rapid efficacy and high therapeutic-to-lethal dose ratio, but with a potential risk of drug dependence. These drugs are lipophilic, allowing for rapid absorption after oral administration, eventually reaching the central nervous system (CNS). Once in the CNS, benzodiazepines bind to the allosteric site of the GABAA receptor. This binding enhances the inhibitory effects of the neurotransmitter GABA. By doing so, they prevent...
2.8K
Sedatives and Hypnotics Drugs: Benzodiazepines01:19

Sedatives and Hypnotics Drugs: Benzodiazepines

Benzodiazepines have both sedative and hypnotic properties. They include compounds such as diazepam (Valium) and alprazolam (Xanax). Structurally, their cores are similar, consisting of the fusion of a benzene ring and a diazepine ring, but they share a common mechanism of action in the central nervous system (CNS).
Benzodiazepines work by enhancing the effects of the inhibitory neurotransmitter GABA. They bind to the GABAA receptor, increasing its affinity for GABA, which opens chloride...
1.1K
CNS Depressants: Barbiturates and Benzodiazepines01:14

CNS Depressants: Barbiturates and Benzodiazepines

CNS depressants include drugs from the category of barbiturates and benzodiazepines. They are valuable medications for managing anxiety disorders and insomnia. Barbiturates, once used to induce and maintain sleep, have been replaced mainly by benzodiazepines due to barbiturate's toxicity, tolerance, and overdose risks. They interact with GABAA receptors, leading to sedation at low doses and potentially coma and death at higher doses. Phenobarbital, a long-acting barbiturate, possesses...
1.5K
Sedatives and Hypnotics Drugs: Barbiturates01:20

Sedatives and Hypnotics Drugs: Barbiturates

Sedatives and hypnotics encompass a drug class that acts on the central nervous system (CNS) to alleviate anxiety, promote relaxation and induce sleep.These drugs function by amplifying the actions of the neurotransmitter γ-aminobutyric acid (GABA), resulting in reduced neuronal activity. Barbiturates, a subset of sedatives and hypnotics first synthesized in the late 1800s, are categorized into ultra-short, short, intermediate, and long-acting groups based on their duration of effect. A...
1.2K