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Therapeutics
Buccal midazolam may be a useful alternative to rectal diazepam for treating acute seizures in refractory epilepsy

https://doi.org/10.1136/ebm.5.1.20

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    (1999) Lancet 353, 623. Scott RC, Besag FM, Neville BG.. Buccal midazolam and rectal diazepam for treatment of prolonged seizures in childhood and adolescence: a randomised trial.. Feb 20;. :. –6.
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 QUESTION: In children and adolescents with refractory epilepsy, is buccal midazolam in solution as effective and safe as rectal diazepam in solution for treating acute seizures?

    Design

    Randomised (allocation concealed*), unblinded,* controlled trial with follow-up to end of seizure.

    Setting

    A residential centre for children and young people with severe epilepsy and other needs in Lingfield, Surrey, UK.

    Patients

    18 of 42 enrolled students with refractory epilepsy (mean age 15 y, 50% girls) who had previously received rectal diazepam for acute seizures and who had a seizure that lasted ≥3 minutes during the study period. Follow-up was complete.

    Intervention

    When a seizure occurred, the student …

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    Footnotes

    • Source of funding: no external funding.

    • For correspondence: Dr R C Scott, Wolfson Centre, Mecklenburgh Square, London WC1N 2AP, UK. FAX +44-(0)171-833-9469.

    • ↵* See glossary.