Midazolam in neonatal seizures with no response to phenobarbital.
The outcome of 45 neonates with EEG-confirmed seizures (ESz) was analyzed with regard to treatment. ESz persisted in 17 of 32 neonates receiving phenobarbital/phenytoin (13 had a poor outcome, 4 died). In contrast, ESz were rapidly controlled in 13 of 13 nonresponders to phenobarbital/phenytoin treated with midazolam (4 had poor outcome, 2 died). Nonresponders to phenobarbital/phenytoin had a significantly worse outcome than responders did. Midazolam effectively controlled ESz in nonresponders to phenobarbital/phenytoin and correlated with significantly improved long-term neurodevelopment.
Castro Conde
J R
JR
Neonatology Service, University Hospital of the Canary Islands, Ofra S/N, La Laguna 28230, Spain. jcastro@ull.es.
Hernández Borges
A A
AA
Doménech Martínez
E
E
González Campo
C
C
Perera Soler
R
R
D000367:Age Factors; D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D001921:Brain / Q000187:drug effects / Q000254:growth & development / Q000503:physiopathology; D004305:Dose-Response Relationship, Drug; D004351:Drug Resistance / Q000502:physiology; D004569:Electroencephalography; D020936:Epilepsy, Benign Neonatal / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D018757:GABA Modulators / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D007231:Infant, Newborn; D008874:Midazolam / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D010634:Phenobarbital / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D012189:Retrospective Studies; D012640:Seizures / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D016896:Treatment Outcome
D000927:Anticonvulsants; D018757:GABA Modulators; D008874:Midazolam; D010634:Phenobarbital