title: [Use of benzodiazepines in prolonged seizures and status epilepticus in the community].
abstract: Prolonged seizures and status epilepticus are common neurological medical emergencies. Early and appropriate treatment is essential to reduce morbidity and mortality. Most seizures occur in the community, so parents and caregivers must be prepared for their management. Benzodiazepines (BZD) are the first-line drugs used, with rectal diazepam (DZPr) being the most commonly used in pre-hospital treatment in Spain. In September 2011, the European Medicines Agency (EMA) authorized the use of oromucosal midazolam (MDZb) for the treatment of prolonged acute convulsive seizures in patients aged 3 months to <18 years. MDZb has a rapid onset, short duration of effect, and avoids first-pass hepatic metabolism. MDZb has shown to be at least as or more effective than DZPr to stop the seizures. Buccal administration is easier and more socially accepted, especially in adolescents and adults. It is a safe drug with similar effects to other BZD; MDZb improves the overall cost-effectiveness of seizures management.
authors.affiliation: Unidad de Neurología Pediátrica, Clínica Universidad de Navarra, Pamplona, Navarra, España.
authors.forename: R
authors.initials: R
authors.lastname: Sánchez-Carpintero
authors.affiliation: Unidad de Neuropediatría, Hospital Reina Sofía, Córdoba, España.
authors.forename: R
authors.initials: R
authors.lastname: Camino
authors.affiliation: Servicio de Neuropediatría, Hospital Universitario La Fe, Valencia, España. Electronic address: smeyers_pat@gva.es.
authors.forename: P
authors.initials: P
authors.lastname: Smeyers
authors.affiliation: Servicio de Neurología Infantil, Hospital Universitario Vall d'Hebron, Barcelona, España.
authors.forename: M
authors.initials: M
authors.lastname: Raspall-Chaure
authors.affiliation: Servicio de Neuropediatría, Hospital Universitario La Paz, Madrid, España.
authors.forename: A
authors.initials: A
authors.lastname: Martínez-Bermejo
authors.affiliation: Sección de Neuropediatría, Hospital Infantil Universitario Niño Jesús, Madrid, España.
authors.forename: M L
authors.initials: ML
authors.lastname: Ruiz-Falcó
authors.affiliation: Unidad de Neuropediatría, Hospital Virgen de la Salud, Toledo, España.
authors.forename: A
authors.initials: A
authors.lastname: Verdú
authors.affiliation: Unidad de Epilepsia Pediátrica, Hospital Universitari Sant Joan de Déu, Barcelona, España.
authors.forename: F X
authors.initials: FX
authors.lastname: Sanmarti
authors.affiliation: Sección de Neuropediatría, Complejo Hospitalario Universitario, Vigo, Pontevedra, España.
authors.forename: O
authors.initials: O
authors.lastname: Blanco
authors.affiliation: Unidad de Neurología Pediátrica, Hospital Universitario, Salamanca, España.
authors.forename: J
authors.initials: J
authors.lastname: Santos Borbujo
authors.affiliation: Servicio de Neuropediatría, Hospital Son Espases, Mallorca, Islas Baleares, España.
authors.forename: G
authors.initials: G
authors.lastname: Picó
authors.affiliation: Viropharma, Madrid, España.
authors.forename: M A
authors.initials: MA
authors.lastname: Cebollero
mesh_terms: D001569:Benzodiazepines / Q000627:therapeutic use*; D002648:Child; D003153:Community Health Services; D006801:Humans; D012640:Seizures / Q000188:drug therapy*; D013226:Status Epilepticus / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D001569:Benzodiazepines
keywords: Benzodiacepinas; Benzodiazepines; Buccal midazolam; Cost-effectiveness; Coste-efectividad; Crisis febriles; Estado epiléptico; Febrile seizures; Midazolam bucal; Seizures treatment; Status epilepticus; Tratamiento de crisis