New Emergency Seizure Treatment for Children1

Oral Drug May Provide Easier, Effective Treatment of Epileptic Seizures

By Jennifer Warner
Reviewed By Brunilda Nazario, MD
WebMD Medical News
on Thursday, July 14, 2005
July 14, 2005 -- A better option for quick control of seizures in children is a drug that can be given
by mouth rather than via the rectum.
Researchers found emergency room treatment with the drug midazolam successfully stopped
seizures within 10 minutes in twice as many children as the currently used rectal treatment.
Rectally given Valium is the treatment of choice for children with uncontrolled seizures when
intravenous drugs (IV) cannot be given.
Treating severe epileptic seizures in children is a common problem in emergency rooms because
the seizures lead to uncontrollable movements that make it difficult to undress or start an IV in a
seizing child.
Midazolam is a benzodiazepine like Valium, which is used as a sedative and to treat people who
have gone into convulsions. It is used under the supervision of doctors.
Easier Epilepsy Treatment?
In the study, researchers compared the effectiveness of oral liquid midazolam with rectal use of
Valium in children treated for severe epileptic seizures at hospital emergency rooms in the U.K.
Researchers treated 219 episodes of seizures involving 177 children aged 6 months and older
with either treatment from 2000 to 2004.
The results, published in this week's issue of The Lancet, showed that when given by mouth,
midazolam successfully ended more seizures (56%) within 10 minutes than rectal Valium did
(27%).
Midazolam was once sold in the U.S. under the brand name Versed. Versed is no longer
available in the U.S., but the generic midazolam is.
In an editorial that accompanies the study, Max Wiznitzer of Rainbow Babies and Children's
Hospital in Ohio says the results show that successful treatment of epileptic seizures in children
doesn't require waiting for an IV.
By reducing the duration of seizures in children, he says oral use of midazolam may reduce the
complications of seizures and the risk of death.
But Wiznitzer says the drug can also be delivered through the nose and may offer an even more
convenient way to treat epileptic seizures. Therefore, he says, more research is needed to see if
an intranasal formulation would be as effective as the oral method used in this study in treating
epileptic seizures in and out of the hospital.

SOURCE: McIntyre, J. The Lancet, July 16, 2005; vol 366: pp 205-210.

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