AI Article Synopsis
- Prolonged seizures and status epilepticus are serious neurological emergencies that require quick and effective treatment to lower risks of severe outcomes.
- Benzodiazepines, particularly rectal diazepam, are the go-to medications for managing seizures, but oromucosal midazolam has been approved for young patients and is shown to be more effective and user-friendly.
- Midazolam is safer, easier to administer, and offers better cost-effectiveness, making it a preferred option for treating extended seizures in the community.
Article 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.
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| http://dx.doi.org/10.1016/j.anpedi.2014.03.023 | DOI Listing |
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