[Intramuscular midazolam in the initial treatment of status epilepticus].
BACKGROUND
The status epilepticus a serious complication of the epileptic syndrome with high rates of morbidity and mortality. Treatment is aimed to a fast control of the crisis.


OBJECTIVE
To evaluate the efficacy and security of intramuscular (IM) midazolam in the initial treatment of status epilepticus.


METHODS
A prospective open clinical trial that included 43 status epilepticus in 38 adult patients. All of the cases received an initial dose of 15 mg IM of midazolam, with a simultaneous oral dose of phenytoin (15 to 20 mg/kg) or carbamazepine (15 mg/kg). If there was immediate control of the seizure but recurrence occurred during the next hours, 15 mg im of midazolam every 8 hours were given, for 24 hours. If there was immediate failure intravenous (IV) midazolam was given.


RESULTS
36 of the 43 status epilepticus were controlled: 30 with only one dose, 3 required additional IM doses, and 3 needed administration of IV midazolam, no patient had neither cardiovascular, respiratory or local complications. The only adverse effect was drowsiness in a variable grade.


CONCLUSIONS
The use of IM midazolam is suggested as the initial treatment in status epilepticus in adults, especially in a low complexity setting, due to its effectiveness, quick action and security.
Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago de Chile, Chile.
D
D
Galdames-Contreras
E
E
Carrasco-Poblete
L
L
Aguilera-Olivares
L
L
Fabres-Oyarzo
D
D
Galdames-Poblete
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014151:Anti-Anxiety Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000927:Anticonvulsants / Q000008:administration & dosage / Q000627:therapeutic use*; D002220:Carbamazepine / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D008874:Midazolam / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D010672:Phenytoin / Q000008:administration & dosage / Q000627:therapeutic use; D011446:Prospective Studies; D013226:Status Epilepticus / Q000188:drug therapy*
D014151:Anti-Anxiety Agents; D000927:Anticonvulsants; D002220:Carbamazepine; D010672:Phenytoin; D008874:Midazolam