comparison of intravenous midazolam drip with intermittent intravenous diazepam in the treatment of refractory serial seizures in children

how to cite this article: fayyazi a, karimzadeh p, torabian s, damadi s, khaje a. comparison of intravenous midazolam drip with intermittent intravenous diazepam in the treatment of refractory serial seizures in children. iran j child neurol 2012; 6(3): 15-19.   objective serial seizures occur commonly in inpatient epileptic children. this type ofseizure due to its characteristics has a significant impact on the patient’s health.untreated serial seizures lead to status epilepticus; therefore, finding a moreeffective treatment for such patients is essential. this study was performed tocompare the outcome of intermittent intravenous diazepam in the pediatricneurology clinic and intravenous midazolam in the pediatric intensive care unit(picu), in order to introduce an alternative treatment for serail seizures. materials & methods in this study, 38 inpatient children aged 6 mo-15 years with refractory serialseizures were treated by first line antiepileptic drugs and then randomlytreated with either intermittent intravenous diazepam in the neurology ward orintravenous midazolam in picu. results fourteen (70%) diazepam group patients and 13 (72.2%) midazolam grouppatients had good response to treatment, there was no significant differencebetween the two groups. four midazolam group patients and two diazepamgroup patients needed mechanical ventilation and were intubated duringtreatment, with no significant difference between the two groups. durationsof mechanical ventilation and picu and hospital stay were not significantlydifferent between the two groups. conclusion intermittent intravenous diazepam is an effective alternative therapy formidazolam drip in the treatment of serial seizures due to similar therapeuticeffects and fewer side effects. references haut sr. seizure clustering. epilepsy behav 2006feb;8(1):50-5. caraballo rh, cersosimo ro, fejerman n. benign focal seizures of adolescence: a prospective study. epilepsia 2004 dec;45(12):1600-3. haut sr, swick c, freeman k, spencer s. seizureclustering during epilepsy monitoring. epilepsia 2002 jul;43(7):711-5. yen dj, chen c, shih yh, guo yc, liu lt, yu hy,et al. antiepileptic drug withdrawal in patients with temporal lobe epilepsy undergoing presurgical video-eeg monitoring. epilepsia 2001 feb;42(2):251-5. rose ab, mccabe ph, gilliam fg, smith bj, boggs jg,ficker dm et al. occurrence of seizure clusters and status epilepticus during inpatient video-eeg monitoring.neurology 2003 mar;60(6):975-8. newmark me, dubinsky s. the significance of seizure clustering: a review of 343 outpatients in an epilepsy clinic. in:dreifuss fe, editor. chronopharmacology intherapy of the epilepsies. new york: raven press; 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