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

authors:

avatar Ali Mazrooei 1 , avatar Seyed-Hassan Tonekaboni 2 , avatar Mohammad Ghofrani 3 , avatar Farhad Mahvelati Shamsabadi 3 , *

1. Department of Pediatrics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Department of Pediatrics, Shahid Beheshti University of Medical Sciences, Tehran & Pediatric Neurology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
1. Department of Pediatrics, Shahid Beheshti University of Medical Sciences, Tehran & Pediatric Neurology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Iranian Journal of Pediatrics: Vol.22, issue 3; 303-308
published online: September 30, 2012
article type: Research Article
received: May 29, 2011
accepted: March 03, 2012

how to cite: Mazrooei A, Tonekaboni S, Ghofrani M, Mahvelati Shamsabadi F. A Comparison of Buccal Midazolam and Intravenous Diazepam for the Acute Treatment of Seizures in Children. Iran J Pediatr. 2012;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.
 

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