A prospective, randomized study comparing intramuscular midazolam with intravenous diazepam for the treatment of seizures in children

James M. Chamberlain*, Michael A. Altieri, Craig Futterman, Grace M. Young, Daniel W. Ochsenschlager, Yeheskel Waisman

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

173 Scopus citations

Abstract

Objective: To compare treatment of ongoing seizures using intramuscular (IM) midazolam versus intravenous (IV) diazepam. Design: Controlled clinical trial. Patients: Children with motor seizures of at least 10 minutes' duration. Main outcome measures: Time to cessation of seizures. Results: Twenty-four patients were enrolled (13 midazolam, 11 diazepam). Initial treatment with either midazolam or diazepam was successful in 22 of the 24 patients. One patient in each group failed therapy and eventually required endotracheal intubation and general anesthesia for convulsive status epilepticus lasting more than one hour. Patients in the midazolam group received medication sooner (3.3 ± 2.0 vs 7.8 ± 3.2 minutes, P = 0.001) and had more rapid cessation of their seizures (7.8 ± 4.1 vs 11.2 ± 3.6, P = 0.047) than patients randomized to receive diazepam. Conclusions: IM midazolam is an effective anticonvulsant for children with motor seizures. Compared to IV diazepam, IM midazolam results in more rapid cessation of seizures because of more rapid palministration. The IM route of administration may be particularly useful in physicians' offices, in the prehospital setting, and for children with difficult IV access.

Original languageEnglish
Pages (from-to)92-94
Number of pages3
JournalPediatric Emergency Care
Volume13
Issue number2
DOIs
StatePublished - Apr 1997

Keywords

  • Status epilepticus
  • diazepam
  • midazolam
  • seizures

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