title: The safety and tolerability of intranasal midazolam in epilepsy.
abstract: Midazolam is a short-acting benzodiazepine that has clearly demonstrated to be an effective option for the acute management of epileptic seizures. It has the advantage of being water-soluble, with a rapid onset of action and it can be administered orally or intranasally, implementing an early intervention at the pre-hospital setting. This article aims to provide an overview of intranasal midazolam in the acute management of epileptic seizures. Available data suggest that midazolam 0.2 mg/kg is as effective as diazepam 0.5 mg/kg, especially in children with febrile or afebrile seizures. Local mucosal irritation seems to occur in less than one-third of cases while serious side effects such as respiratory depression in about 1%. Future studies need to be focused on adults and optimized technologies for intranasal delivery. Moreover, comparisons with buccal midazolam are warranted.
authors.affiliation: Epilepsy Group, Atkinson Morley Regional Neuroscience Centre, St George's Hospital, London, UK.
authors.forename: Marco
authors.initials: M
authors.lastname: Mula
mesh_terms: D000281:Administration, Intranasal; D000927:Anticonvulsants / Q000008:administration & dosage* / Q000009:adverse effects; D004827:Epilepsy / Q000188:drug therapy*; D006801:Humans; D008874:Midazolam / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D000927:Anticonvulsants; D008874:Midazolam
keywords: antiepileptic drug; epilepsy; intranasal; midazolam; status epilepticus; treatment