Intravenous midazolam for the treatment of refractory status epilepticus.
OBJECTIVE
To determine the usefulness of midazolam as a therapeutic agent for status epilepticus refractory to conventional treatment.


METHODS
Retrospective study.


METHODS
ICUs of two university hospitals.


METHODS
Seven patients with refractory status epilepticus who failed treatment with diazepam, lorazepam, and phenytoin, with or without phenobarbital. All patients received mechanical ventilation before receiving midazolam.


METHODS
Intravenous midazolam by bolus administration followed by infusion.


RESULTS
Midazolam terminated status epilepticus in all patients in less than 100 secs, as determined by clinical observation (three patients) or electroencephalographic monitoring (four patients). One patient developed mild hypotension.


CONCLUSIONS
In this small study, midazolam appears to be an effective and safe alternative to high-dose barbiturate coma for the termination of status epilepticus when conventional agents have failed.
Kumar
A
A
Department of Internal Medicine, University of Manitoba Health Sciences Center, Winnipeg, Canada.
Bleck
T P
TP
D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004351:Drug Resistance; D004569:Electroencephalography / Q000187:drug effects; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007262:Infusions, Intravenous; D007275:Injections, Intravenous; D008297:Male; D008874:Midazolam / Q000627:therapeutic use*; D012189:Retrospective Studies; D013226:Status Epilepticus / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology
D000927:Anticonvulsants; D008874:Midazolam