Reflex Anoxic Seizures Induced by Needle Stick and Successfully Treated With Intranasal Midazolam

Area of Science:

• Neurology
• Pediatric Neurology
• Clinical Neurophysiology

Background:

• Reflex anoxic seizures (RAS) are a type of convulsive syncope, predominantly observed in pediatric populations.
• While typically benign, RAS can, in rare instances, transition into true epileptic seizures.
• Current treatment strategies for RAS lack established consensus.

Observation:

• This report details a rare case of reflex anoxic seizures in an adult patient.
• Electroencephalogram (EEG) monitoring was performed during a seizure event.
• The patient experienced a successful intervention with intranasal midazolam, which prevented seizure recurrence.

Findings:

• The successful use of intranasal midazolam suggests a significant role of anxiety in precipitating RAS in this adult patient.
• EEG monitoring provided valuable data during the event.

Implications:

• Reflex anoxic seizures in adults are infrequently encountered and require accurate diagnosis.
• Effective management, as demonstrated by this case, can substantially enhance patient quality of life.
• This case underscores the potential utility of intranasal midazolam in managing RAS, particularly when anxiety is a contributing factor.