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Systematic Review Finds Intranasal Midazolam Comparable To Intravenous Or Rectal Administration Of Diazepam For Treatment Of Acute Seizure Emergencies In Pediatric Patients
Date:11/1/2013

emergencies in pediatric patients.  Seven identified studies evaluated intranasal midazolam in approximately 200 pediatric patients.  All of the studies compared intranasal midazolam to diazepam delivered either intravenously (n=4) or by rectal administration (n=3).  Intranasal administration was achieved by spraying (n=2) or dripping (n=5) midazolam intravenous solution into the nose.  All studies demonstrated intranasal midazolam (0.2 mg/kg) was as effective as intravenous or rectal diazepam (0.2 – 0.5 mg/kg) in treating seizure emergencies with a rapid (<5 min) onset of action.  Additionally, intranasal midazolam and intravenous or rectal diazepam demonstrated similar safety profiles, with few reports of respiratory depression across all treatments.

About Epilepsy
Epilepsy is a medical condition that causes seizures affecting a variety of cognitive and physical functions.  More than two million people in the U.S. are estimated to be affected by epilepsy with about 200,000 new cases of epilepsy diagnosed each year. 1

About Seizure Clusters
Seizure clusters, also referred to as acute repetitive seizures or intermittent bouts of increased seizure activity, are multiple seizures which occur over a relatively brief period of time with a pattern distinguishable from the usual seizure pattern.2   Typically, there is recovery between seizures.3

Reports of seizure cluster prevalence vary, but it has been estimated that approximately 22% of the intractable epilepsy population (approximately 152,000 people) experience them. 4,5,6,7  

Inadequate treatment of seizure clusters may potentially impact the safety of an epilepsy patient, may result in emergency room visits, and/or may evolve into status epilepticus, a potentially life-threatening condition.8,9,10  Benzodiazepines are the treatment of choice for management
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SOURCE Upsher-Smith
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