efficacy of continuous high dose midazolam infusion in childhood refractory generalized convulsive status epilepticus

objecive prolonged and uncontrolled refractory status epilepticus (se) is a life-threatening medical emergency in children (1,2,3). there is no consensus on the optimal therapy for refractory status epilepticus (1). the aim of this study was to develop a new method for treating patients with refractory status epilepticus. materials & methods ten children with refractory status epilepticus in mofid hospital, who did not respond to 10 μg/kg per min of intravenous midazolam, had their dose of midazolam increased to 30 μg/kg per min. all children were monitored for the development of side effects. results ten children with no response to low-dose midazolam were given a higher dose of midazolam, and 5 (50%) children had a good response. these patients had significantly different response to high-dose midazolam. one patient in the high-dose midazolam group was intubated and required mechanical ventilation. the duration of stay in the hospital and picu and on mechanical ventilation in patients with no response to low-dose midazolam following with other drugs was longer than in the high-dose midazolam group. no death occurred in high dose midazolam group. conclusion high-midazolam dose drip infusion is a safe and effective protocol for refractory status epilepticus in children.