Use of Midazolam for Refractory Status

Epilepticus in Pediatric Patients
 

John M.Pellock,MD

ABSTRACT

      Status epilepticus is more common among children than young adults. Children might be less likely to die and might be resistant to permanent neurologic due to status epilepticus, but significant sequelae also have been demonstrated. Aggressive intervention and rapid termination of seizures contribute significantly to better prognosis and reduced mortality from status epilepticus . Initial treatment of status epilepticus typically consists of either diazepam or lorazepam, immediately followed by phenytoin or phenobarbital. However, approximately 10% to 15% of status epilepticus episodes are refractory to these conventional therapies . Traditionally, refractory status epilepticus is treated with barbiturate coma or general anesthetics , both of which require invasive cardiorespiratory and hemodynamic monitoring and are associated with significant complications. Midazolam is a water – soluble benzodiazepine with a fast onset of action , a short half-life and inactive metabolites that has been very effective in terminating seizures refractory to diazepam,lorazepam,phenytion,and phenobarbital in pepediatric patients . Midazolam is a valuable treatment option for refractory status epilepticus, especially in pediatric patients. (J Child Neurol 1998;13:581-587).


Journal of Child Neurology


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