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AES: Buccal Midazolam May Be Superior to Diazepam in Paediatric Seizure Rescue Situations By Bonnie Darves NEW ORLEANS, LA -- December 9, 2004 -- The relatively new epilepsy rescue medication, buccal midazolam, may be slightly more effective in the emergency treatment of acute tonic-clonic seizures in children, with fewer adverse effects than the standard rectal diazepam, researchers reported here on December 7th at the American Epilespy Society's Annual Meeting. The multicenter comparative randomised trial showed that buccal midazolam reversed acute seizures more rapidly than diazepam in the 219 patients studied, without producing the serious respiratory depression seen in some children who received diazepam in rescue situations, said the study's chief investigator Richard Appleton, MD, neurologist, Roald Dahl EEG Unit, Royal Liverpool Hospital, Liverpool, United Kingdom. In the trial, patients, whose median age was 3 years, received either buccal midazolam or diazepam for acute seizure. Seizure reveral within 10 minutes occurred in 65% of buccal midazolam subjects versus 41% of diazepam subjects, and the percentage of patients requiring add-on IV lorazepam for continued seizure activity was 36% in the buccal midasolam group compared to 57.3% in the diazepam group. "We found that seizure reversal within 10 minutes occurred in 61 of the patients on buccal midasolam versus 30 who received diazepam, and that fewer of those patients re-seized," Dr. Appleton said. In response to concerns raised about the small sample size (109 patients) Dr. Appleton said that the drug's apparent safety, at this point, was a plus and that staff administering the medication reported that it was easier to use, which he perceived as a benefit. "I see no issues with the drug's safety," he said. All patients in the study who received muccal midasolam were treated in a hospital emergecy room setting. He added that no patient in the study received the study drug more than twice. [Presentation title: "Randomised Controlled Trial of Buccal Midazolam Versus Rectal Diazepam for the Emergency Treatment of Seizures in Children." Abstract B.02] E-mail this page to a friend or colleague! To print, use this version