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    Buccal midazolam for treatment of prolonged seizures in children
    (Elsevier Science Bv, 2003) Kutlu, NO; Dogrul, M; Yakinci, C; Soylu, H
    Midazolam is a relatively new anticonvulsive agent in the benzodiazepine group. It has a short onset of duration and is practical for use, providing several alternatives such as intravenous, intramuscular, and intranasal routes. The buccal route could be an alternative choice for seizure control in an emergency setting. However, no sufficient reports are available on buccal midazolam administration. The present study was designated to examine the efficacy of buccal midazolam in children at different ages with seizures of more than 5 min duration. Nineteen previously unreported children, aged from 1 month to 15 years, were treated with a 0.3 mg/kg dose of buccal midazolam; 13 had prolonged seizures, and six had status epilepticus, with a duration of 5-45 min (mean 22 min). Sixteen of 19 seizures (84.2%) stopped within 10 min of buccal midazolam being given. The drug efficacy in patients with status epilepticus was 50%. However, all patients with convulsions shorter than 30 min showed a perfect response (100%). Convulsion episodes stopped within 3.89 +/- 2.22 min (median time 3 min). Seizure duration was correlated with cessation of seizure (r = 0.76, P < 0.001). No clinically important side effects were seen in any patient. On the basis of this experience, we concluded that a 0.3 mg/kg dose of buccal administration of midazolam might offer an effective treatment in all ages of children. (C) 2002 Elsevier Science B.V. All rights reserved.
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    Intranasal midazolam for prolonged convulsive seizures
    (Elsevier Science Bv, 2000) Kutlu, NO; Yakinci, C; Dogrul, M; Durmaz, Y
    In order to determine the efficiency of intranasal midazolam in prolonged convulsive episodes, we conducted a prospective study in children with various types of seizures. Nine patients (six buys, three girls; age range 6 months to 9 years) with prolonged convulsions lasting more than 10 min were treated with intranasal midazolam, 0.3 mg/kg. The success rate was 100% with only one case requiring a second dose. Estimated duration of seizures was 12-30 min (mean 18.6) while mean time elapsed until cessation of seizures was 139.6 s (range 60-480). No significant adverse effects were noted except fur one patient who had seizures secondary to serious CNS infection and respiratory depression after intranasal midazolam. (C) 2000 Elsevier Science B.V. All rights reserved.