A Comparison of Buccal Midazolam and Intravenous Diazepam for the Acute Treatment of Seizures in Children

Ali Mazrooei; Seyed-Hassan Tonekaboni; Mohammad Ghofrani; Farhad Mahvelati Shamsabadi

IJ Pediatrics

The Scientific Journal of Growth & Development Research Center

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A Comparison of Buccal Midazolam and Intravenous Diazepam for the Acute Treatment of Seizures in Children

Author(s):

Ali Mazrooei¹,

Seyed-Hassan Tonekaboni²,

Mohammad Ghofrani³,

Farhad Mahvelati Shamsabadi^3,*

11. Department of Pediatrics, Shahid Beheshti University of Medical Sciences, Tehran, Iran

3Department of Pediatrics, Shahid Beheshti University of Medical Sciences, Tehran & Pediatric Neurology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

31. Department of Pediatrics, Shahid Beheshti University of Medical Sciences, Tehran & Pediatric Neurology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

IJ Pediatrics:Vol. 22, issue 3; 303-308

Published online:Sep 30, 2012

Article type:Research Article

Received:May 29, 2011

Accepted:Mar 03, 2012

How to Cite:Ali MazrooeiSeyed-Hassan TonekaboniMohammad GhofraniFarhad Mahvelati ShamsabadiA Comparison of Buccal Midazolam and Intravenous Diazepam for the Acute Treatment of Seizures in Children.Iran J Pediatr.22(3):303-308.

Abstract

Objective: The purpose of the present study is to compare efficacy and safety of buccal midazolam with intravenous diazepam in control of seizures in Iranian children.
Methods: This is a randomized clinical trial. 92 patients with acute seizures, ranging from 6 months to 14 years were randomly assigned to receive either buccal midazolam (32 cases) or intravenous diazepam (60 cases) at the emergency department of a children's hospital. The primary outcome of this study was cessation of visible seizure activity within 5 minutes from administration of the first dosage. The second dosage was used in case the seizure remained uncontrolled 5 minutes after the first one.
Findings: In the midazolam group, 22 (68.8%) patients were relieved from seizures in 10 minutes. Meanwhile, diazepam controlled the episodes of 42 (70%) patients within 10 minutes. The difference was, however, not statistically significant (P=0.9). The mean time required to control the convulsive episodes after administration of medications was not statistically significant (P=0.09). No significant side effects were observed in either group. Nevertheless, the risk of respiratory failure in intravenous diazepam is greater than in buccal midazolam.
Conclusion: Buccal midazolam is as effective as and safer than intravenous diazepam in control of seizures.

Keywords

Midazolam

Diazepam

Myoclonic Seizure Disorder

Buccal Drug Administration

Intravenous Injections

Childhood

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