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Arch Dis Child 1997;76:445-448 ( May )

Continuous midazolam infusion as treatment of status epilepticus

Roshan Lal Koul,a Guru Raj Aithala,b Alexander Chacko,b Rajendra Joshi,b Mussalem Seif Elbualyb

a Division of Paediatric Neurology, Department of Child Health, Sultan Qaboos University Hospital, PO Box 35, Al Khod 123, Sultanate of Oman, b Department of Child Health, Sultan Qaboos University Hospital, Al Khod, Sultanate of Oman

Correspondence to: Dr Lal Koul.

Accepted 5 February 1997

In a tertiary referral centre, midazolam infusion was tried as treatment for 20 children with status epilepticus over a period of two years. The mean age of the children was 4.07 years. Twelve children with refractory status epilepticus had received intravenous or per rectal diazepam and intravenous phenytoin/phenobarbitone or both before midazolam was given (0.15 mg/kg bolus followed by 1-5 µg/kg/min infusion). Eight children required only midazolam to control the established status epilepticus. The seizures were controlled in 19 children. The mean time required for complete cessation of seizures was 0.9 hours. The mean infusion rate required was 2.0 µg/kg/min. All children had regained full consciousness by a mean of 5.1 hours after discontinuation of midazolam treatment. No metabolic derangement or compromise of vital functions was noted in any of the children. Midazolam infusion is thus an effective and safe therapeutic approach for the management of childhood status epilepticus.

Keywords: status epilepticus; refractory; midazolam

© 1997 by Archives of Disease in Childhood


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