title: Nasal and buccal treatment of midazolam in epileptic seizures in pediatrics.
abstract: Acute seizure and status epilepticus constitute major medical emergencies in children. Four to six percent of children will have at least one seizure in the first 16 years of life. Status epilepticus is a common neurological emergency in childhood and is associated with significant morbidity and mortality. The early application of antiepileptic treatment is very important. Because early treatment prevents the status epilepticus formation and shortens the duration of seizure activity. For this reason administration of anticonvulsant therapy in the prehospital setting is very important. Seizures generally begin outside the hospital, and thus parents and caregivers need simple, safe and effective treatment options to ensure early intervention. The only special preparation used for this purpose is rectal diazepam but has some disadvantages. Midazolam is a safe, short-acting benzodiazepin. It is suitable to use oral, buccal, nasal, im and iv routes. This provides a wide area for clinical applications. Recently there are many clinical studies about the usage of nasal and buccal midazolam for treatment of pediatric epileptic seizures. The nasal and buccal applications in pediatric seizures are very practical and effective. Parents and caregivers can apply easily outside the hospital.
authors: Medical Faculty, Erciyes University, 38039 Kayseri, Turkey.
authors: Ayşe
authors: A
authors: Ulgey
authors: Recep
authors: R
authors: Aksu
authors: Cihangir
authors: C
authors: Bicer
keywords: buccal midazolam; midazolam; nasal midazolam; seizure
references: Brain Dev. 2003 Jun;25(4):275-8
references: 12767460
references: ASDC J Dent Child. 1994 May-Jun;61(3):175-81
references: 8089345
references: Paediatr Anaesth. 2012 Sep;22(9):871-6
references: 22268591
references: Br J Clin Pharmacol. 1998 Sep;46(3):203-6
references: 9764959
references: Exp Neurol. 1988 Aug;101(2):267-75
references: 3396644
references: Pediatr Emerg Care. 2007 Mar;23(3):148-53
references: 17413428
references: Pharmacotherapy. 1985 May-Jun;5(3):138-55
references: 3161005
references: Indian J Pediatr. 2011 Feb;78(2):219-26
references: 21153571
references: Anesthesiology. 1985 Mar;62(3):310-24
references: 3156545
references: Lancet. 1995 Jul 15;346(8968):145-7
references: 7603229
references: Ann Emerg Med. 1994 Dec;24(6):1065-73
references: 7978587
references: Pediatrics. 2008 Jan;121(1):e58-64
references: 18166545
references: Ann Emerg Med. 1994 Dec;24(6):1170-2
references: 7978603
references: Lancet. 1999 Feb 20;353(9153):623-6
references: 10030327
references: Dev Med Child Neurol. 1996 Nov;38(11):1037-45
references: 8913185
references: Lancet. 2005 Jul 16-22;366(9481):205-10
references: 16023510
references: Epilepsy Behav. 2004 Apr;5(2):253-5
references: 15123028
references: Neurology. 2002 Nov 12;59(9 Suppl 5):S3-6
references: 12428025
references: Pediatrics. 1993 Oct;92(4):638
references: 8414846
references: Crit Care. 2002 Apr;6(2):137-42
references: 11983039
references: N Engl J Med. 1998 Apr 2;338(14):970-6
references: 9521986
references: Anesthesiology. 1990 Nov;73(5):831-4
references: 2240672
references: Arch Pediatr Adolesc Med. 2010 Aug;164(8):747-53
references: 20679166
references: Indian J Pediatr. 2012 Apr;79(4):510-7
references: 22120613
references: Epilepsia. 1999;40 Suppl 1:S3-8; discussion S21-2
references: 10421556
references: J Emerg Med. 1991 Jul-Aug;9(4):247-51
references: 1861059
references: Brain Dev. 2000 Sep;22(6):359-61
references: 11042416
references: J Paediatr Child Health. 2004 Sep-Oct;40(9-10):556-8
references: 15367152
references: Epilepsia. 2010 Mar;51(3):478-82
references: 19817813
references: Am J Emerg Med. 2006 May;24(3):343-6
references: 16635708
references: Seizure. 2000 Sep;9(6):417-22
references: 10985999
references: Lancet. 1998 Aug 22;352(9128):620
references: 9746026
references: Eur J Paediatr Neurol. 1999;3(2):73-7
references: 10700542
references: Pediatr Neurol. 2006 May;34(5):355-9
references: 16647994
references: J Child Neurol. 2000 Dec;15(12):833-5
references: 11198507
references: DICP. 1990 Jul-Aug;24(7-8):695-7
references: 2375138
references: Pediatr Dent. 1993 Jul-Aug;15(4):237-41
references: 8247896
references: J Emerg Med. 1997 May-Jun;15(3):357-65
references: 9258787
references: Brain Dev. 2009 Nov;31(10):744-9
references: 19114297
references: Ann Emerg Med. 1990 Sep;19(9):1006-9
references: 2203289
references: Drugs. 1984 Dec;28(6):519-43
references: 6394264