J Korean Child Neurol Soc.  2000 May;8(1):80-86.

The Effect of Intraverious Continuous Infuction Midazolam against Refractory Status Epilepticus in Children

• Oh HA
• Kim CJ
• Park KW
• Woo YJ

Abstract

PURPOSE: Refractory status epilepticus refers to patients who do not respond properly to adequate first-line drug treatment such as diazepam, phenytoin, phenobaribital, lorazepam and show longer than 60 minute seizure. This study was designed to determine the efficacy and safety of midazolam given as a continuous infusion in the treatment of status epilepticus in children.
METHODS
Midazolam was infused to twelve children with seizures, for whom two time repeated doses of 0.3mg/kg of diazepam, 20mg/kg of phenobarbital, and 20mg/kg of phenytoin failed to bring the episode under control. All patients received a bolus of midazolam(0.15mg/kg) followed by a continuous infusion at 1microgram/kg/min. The dose was increased every 15 min until the episode of seizure was brought under control. Time required to control seizures, infusion rate, and side-effects were monitored.
RESULTS
The mean age of the patient population was 6.06 yrs(range 2 months to 16 yrs; 6 females and 6 males). In 11 patients, seizures were controlled in a mean time of 60.1 min(range 15-180 min). The mean infusion rate was 8.5microgram/kg/min(range 1-20). The total treatment duration was 17.6 days(range 1-54 days). One patient who was confirmed to have cortical dysplasia failed to respond. Two of the patients showed respiratory depression and bradycardia.
CONCLUSION
Midazolam is an effective and safe drug to control refractory seizures in children with status epilepticus.

MeSH Terms

Bradycardia
Child*
Diazepam
Female
Humans
Lorazepam
Malformations of Cortical Development
Midazolam*
Phenobarbital
Phenytoin
Respiratory Insufficiency
Seizures
Status Epilepticus*
Diazepam
Lorazepam
Midazolam
Phenobarbital
Phenytoin