Volume : 7, Issue : 2, February - 2018

Comparison of intranasal midazolam with intravenous diazepam for treating acute seizures in children: A prospective randomized study

Neeraj Singh, J Chhatwal

Abstract :

<p>&nbsp;</p> <p class="MsoNormal" style="line-height:150%"><b>Objective:</b> To study and compare the efficacy and safety of intranasal midazolam and intravenous diazepam for treatment of children with acute seizures.<o:p></o:p></p> <p class="MsoNormal" style="text-align:justify;line-height:150%"><b style="mso-bidi-font-weight:normal">Subjects:</b> Children beyond neonatal period hospitalized with acute seizures. A total of hundred seizure episodes, 50 in either midazolam or diazepam group. <o:p></o:p></p> <p class="MsoNormal" style="line-height:150%;mso-layout-grid-align:none;&#10;text-autospace:none"><b>Interventions: </b>Intranasal midazolam (0.2 mg/kg) and intravenous diazepam (0.3 mg/kg).<o:p></o:p></p> <p class="MsoNormal" style="text-align:justify;line-height:150%"><b style="mso-bidi-font-weight:normal">Results:</b> In the midazolam group, the treatment was initiated within 30s in 78% of the patients as compared to 24% in the diazepam group. There was a significant difference between mean time taken from contact with physician to drug administration between the midazolam (29.02 &plusmn; 32.64s) and diazepam group (51.92 &plusmn; 33.61s) [p &lt; 0.01]. The mean time of contact with physician to cessation of seizure was almost comparable between the two groups (93.07 &plusmn; 74.23s Vs 95.74 &plusmn; 79.79s). No significant adverse events were noted in either group. <o:p></o:p></p> <p class="MsoNormal" style="text-align:justify;line-height:150%"><b style="mso-bidi-font-weight:normal">Conclusions: <span style="mso-spacerun:yes">&nbsp;&nbsp;</span></b>Treatment could be initiated quickly with intranasal midazolam and was efficacious for seizure control. As it is easy to administer, it can be safely recommended for use in domiciliary and home settings for control of acute seizures in children.<o:p></o:p></p>