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Delay in benzodiazepine administration is associated with increased need for anesthetic coma therapy in children with

Kento Souma1, Hiroshi Yamaguchi1, Takuya Ueda1

  • 1Department of Pediatrics, Kobe University Graduate School of Medicine, Hyogo, Japan.

Epilepsy Research
|August 19, 2026
PubMed

Insights

Delayed treatment for febrile status epilepticus (FSE) in children may increase the need for intensive neurocritical care, such as anesthetic coma therapy (ACT). Early benzodiazepine (BZD) administration is crucial for better outcomes in pediatric FSE management.

Area of Science:

  • Pediatric Neurology
  • Critical Care Medicine
  • Epileptology

Background:

  • Febrile status epilepticus (FSE) is linked to acute encephalopathy (AE) and poorer outcomes with delayed antiseizure medication.
  • The impact of treatment timing on in-hospital care and short-term outcomes for pediatric FSE is not well understood.

Purpose of the Study:

  • To investigate the effect of early versus delayed benzodiazepine (BZD) administration on the management and outcomes of pediatric patients with FSE.

Main Methods:

  • A retrospective cohort study of 93 children with FSE admitted between January 2020 and April 2023.
  • Patients receiving BZDs within 80 minutes were categorized into early (≤40 min) and late (41-80 min) groups.
  • Outcomes included impaired consciousness, anesthetic coma therapy (ACT) induction, AE development, and neurological sequelae.

Main Results:

  • The late group (LG) had a significantly higher rate of ACT induction compared to the early group (EG) (22.7% vs. 3.7%).
  • While AE and neurological sequelae showed no significant differences, ACT rates increased with delayed BZD administration.
  • Impaired consciousness at 6 hours affected 35.4% and 17.2% required ACT.

Conclusions:

  • Delayed BZD administration in pediatric FSE may correlate with a higher need for intensive neurocritical care, specifically ACT.
  • Early intervention with BZDs is suggested to potentially mitigate the need for advanced interventions in FSE.
Abstract

Keywords:
ACTASMAcute encephalopathyBZDFebrile seizureStatus epilepticus

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