title: Efficacy of continuous midazolam infusion and mortality in childhood refractory generalized convulsive status epilepticus.
abstract: OBJECTIVE
  Continuous midazolam infusion is commonly used for the management of status epilepticus (SE). The purpose of this study was to assess the efficacy of midazolam and mortality in childhood refractory generalized convulsive SE.
  
  
  METHODS
  We included 27 children with refractory generalized convulsive SE. Midazolam was given 0.2 mg/kg as bolus, followed by 1-5 microg/kg/min as continuous infusion. Clinical data and response to treatment were recorded for each patient.
  
  
  RESULTS
  Acute symptomatic SE accounted for 52%, and central nervous system (CNS) infections were the most frequently associated etiologic condition (44%). Complete control of seizures was achieved with midazolam infusion in the 26 (96%) children within 65 min; at a mean midazolam infusion rate of 3.1 microg/kg/min. Adverse effects such as hypotension, bradycardia or respiratory depression did not occur during midazolam infusion. In one (4%) patient with acute meningoencephalitis, SE could not be controlled. Five (19%) patients died; four had acute symptomatic aetiology and one had progressive encephalopathy.
  
  
  CONCLUSIONS
  Midazolam is effective and safe in the control of refractory generalized convulsive SE. The response to treatment and mortality were related to the underlying aetiology.
authors.affiliation: Dokuz Eylul University, School of Medicine, Department of Paediatrics, Izmir, Turkey. durgulozdemir@yahoo.com
authors.forename: Durgul
authors.initials: D
authors.lastname: Ozdemir
authors.forename: Pamir
authors.initials: P
authors.lastname: Gulez
authors.forename: Nedret
authors.initials: N
authors.lastname: Uran
authors.forename: Gurol
authors.initials: G
authors.lastname: Yendur
authors.forename: Tulay
authors.initials: T
authors.lastname: Kavakli
authors.forename: Adem
authors.initials: A
authors.lastname: Aydin
mesh_terms: D000293:Adolescent; D001919:Bradycardia / Q000139:chemically induced; D002648:Child; D002675:Child, Preschool; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D007022:Hypotension / Q000139:chemically induced; D007223:Infant; D007262:Infusions, Intravenous; D008297:Male; D008874:Midazolam / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D012131:Respiratory Insufficiency / Q000139:chemically induced; D013226:Status Epilepticus / Q000188:drug therapy* / Q000401:mortality; D015996:Survival Rate
chemical_list: D006993:Hypnotics and Sedatives; D008874:Midazolam