title: Comparison of intranasal and intravenous diazepam on status epilepticus in stroke patients: a retrospective cohort study.
abstract: Administering diazepam intravenously or rectally in an adult with status epilepticus can be difficult and time consuming. The aim of this study was to examine whether intranasal diazepam is an effective alternative to intravenous diazepam when treating status epilepticus. We undertook a retrospective cohort study based on the medical records of 19 stroke patients presenting with status epilepticus to our institution. We measured the time between arrival at the hospital, the intravenous or intranasal administration of diazepam, and the seizure termination. Intranasal diazepam was administered about 9 times faster than intravenous diazepam (1 vs 9.5 minutes, P = 0.001), resulting in about 3-fold reduction in the time to termination of seizure activity after arrival at the hospital (3 minutes compared with 9.5 minutes in the intravenous group, P = 0.030). No adverse effects of intranasal diazepam were evident from the medical records. Intranasal diazepam administration is safer, easier, and quicker than intravenous administration.
authors.affiliation: From the Department of Emergency and Critical Care Medicine, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan.
authors.forename: Ryota
authors.initials: R
authors.lastname: Inokuchi
authors.forename: Naoko
authors.initials: N
authors.lastname: Ohashi-Fukuda
authors.forename: Kensuke
authors.initials: K
authors.lastname: Nakamura
authors.forename: Tomoki
authors.initials: T
authors.lastname: Wada
authors.forename: Masataka
authors.initials: M
authors.lastname: Gunshin
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Kitsuta
authors.forename: Susumu
authors.initials: S
authors.lastname: Nakajima
authors.forename: Naoki
authors.initials: N
authors.lastname: Yahagi
mesh_terms: D000281:Administration, Intranasal; D061605:Administration, Intravenous; D000368:Aged; D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000008:administration & dosage / Q000627:therapeutic use*; D003975:Diazepam; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013226:Status Epilepticus / Q000188:drug therapy* / Q000209:etiology*; D020521:Stroke / Q000150:complications*; D013997:Time Factors
chemical_list: D000927:Anticonvulsants; D003975:Diazepam