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Wayne State research reveals improved method for paramedics to stop prolonged seizures
Date:2/16/2012

ime. Applying an intramuscular injection using a device similar to the EpiPen which is used to treat severe allergic reactions is easier, faster and more reliable, especially in patients having convulsions. The researchers sought to determine whether an intramuscular injection, which quickly delivers anticonvulsant medicine into a patient's thigh muscle, is as safe and effective as giving medicine directly into a vein. The study, which was carried out by paramedics, compared how well delivery by each method stopped patients' seizures by the time the ambulance arrived at the emergency department.

Midazolam and lorazepam are benzodiazepines, a class of sedating anticonvulsant drugs. Midazolam was a candidate for injection because it is rapidly absorbed from muscle. Lorazepam must be given by IV.

The study, published in the Feb. 16 issue of the New England Journal of Medicine, found that 73 percent of patients in the group receiving midazolam via direct injection into the thigh muscle were seizure-free upon arrival at the hospital, compared to 63 percent of patients who received IV treatment with lorazepam. Patients treated with midazolam also were less likely to require hospitalization than those receiving intravenous lorazepam. Among those admitted, both groups had similarly low rates of recurrent seizures.

"This study demonstrated that giving an intramuscular dose of medication is just as effective in stopping the prolonged seizure as is giving an intravenous medication," said Welch, who also serves as director of clinical research for the department, as well as principal investigator of the Wayne State University hub of the Neurological Emergencies Treatment Trials (NETT) Network. "Since it can be very difficult to establish an IV in a patient who is seizing, giving a medication intramuscularly is easier and may lead to better outcomes. In order to reduce the potential for brain damage, stopping the seizure as soon as possible is
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Contact: Julie O'Connor
julie.oconnor@wayne.edu
313-577-8845
Wayne State University - Office of the Vice President for Research
Source:Eurekalert

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