Efficacy of Intravenous Midazolam for Status Epilepticus in Childhood

Kitami Hayashi; Makiko Osawa; Masao Aihara; Tatsuro Izumi; Yoko Ohtsuka; Kazuhiro Haginoya; Ikuko Kato; Kenichiro Kaneko; Kenji Sugai; Takao Takahashi; Shin ichiro Hamano; Makoto Matsukura; Hisao Miura; Kimio Minagawa; Tsunekazu Yamano; Hitoshi Yamamoto; Hideo Yamanouchi; Hideto Yoshikawa

doi:10.1016/j.pediatrneurol.2007.02.012

Efficacy of Intravenous Midazolam for Status Epilepticus in Childhood

Kitami Hayashi, Makiko Osawa, Masao Aihara, Tatsuro Izumi, Yoko Ohtsuka, Kazuhiro Haginoya, Ikuko Kato, Kenichiro Kaneko, Kenji Sugai, Takao Takahashi, Shin ichiro Hamano, Makoto Matsukura, Hisao Miura, Kimio Minagawa, Tsunekazu Yamano, Hitoshi Yamamoto, Hideo Yamanouchi, Hideto Yoshikawa

Research output: Contribution to journal › Article › peer-review

72 Citations (Scopus)

Abstract

A retrospective multicenter study was conducted, designed to evaluate the efficacy and safety of midazolam for the treatment of status epilepticus. The subjects were 358 inpatients who received intravenous midazolam therapy for status epilepticus. The mean age was 48.6 ± 46.5 months. The underlying disorder was epilepsy in 195 cases, and acute symptomatic diseases in 163 (encephalitis or encephalopathy in 88 cases). Midazolam was administered as a bolus dose (0.25 ± 0.21 mg/kg), followed if necessary by continuous infusion (0.26 ± 0.25 mg/kg/hr). The bolus injection was effective in 162 (56.6%) of the 286 cases. In the end, seizure suppression was obtained in 231 cases (64.5% of the total). The effectiveness of midazolam was lower in patients in whom midazolam was initiated more than 3 hours after seizure onset, and this tendency was particularly marked in the epilepsy group. During the treatment period, 10 patients died, but none of these deaths were associated with midazolam therapy. The incidence and types of adverse events were consistent with previously reported data. The present results indicate that midazolam is highly effective for the management of status epilepticus, if used sufficiently early after seizure onset.

Original language	English
Pages (from-to)	366-372
Number of pages	7
Journal	Pediatric Neurology
Volume	36
Issue number	6
DOIs	https://doi.org/10.1016/j.pediatrneurol.2007.02.012
Publication status	Published - 2007 Jun
Externally published	Yes

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health
Neurology
Developmental Neuroscience
Clinical Neurology

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10.1016/j.pediatrneurol.2007.02.012

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Hayashi, K., Osawa, M., Aihara, M., Izumi, T., Ohtsuka, Y., Haginoya, K., Kato, I., Kaneko, K., Sugai, K., Takahashi, T., Hamano, S. I., Matsukura, M., Miura, H., Minagawa, K., Yamano, T., Yamamoto, H., Yamanouchi, H., & Yoshikawa, H. (2007). Efficacy of Intravenous Midazolam for Status Epilepticus in Childhood. Pediatric Neurology, 36(6), 366-372. https://doi.org/10.1016/j.pediatrneurol.2007.02.012

Hayashi, K, Osawa, M, Aihara, M, Izumi, T, Ohtsuka, Y, Haginoya, K, Kato, I, Kaneko, K, Sugai, K, Takahashi, T, Hamano, SI, Matsukura, M, Miura, H, Minagawa, K, Yamano, T, Yamamoto, H, Yamanouchi, H & Yoshikawa, H 2007, 'Efficacy of Intravenous Midazolam for Status Epilepticus in Childhood', Pediatric Neurology, vol. 36, no. 6, pp. 366-372. https://doi.org/10.1016/j.pediatrneurol.2007.02.012

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title = "Efficacy of Intravenous Midazolam for Status Epilepticus in Childhood",

abstract = "A retrospective multicenter study was conducted, designed to evaluate the efficacy and safety of midazolam for the treatment of status epilepticus. The subjects were 358 inpatients who received intravenous midazolam therapy for status epilepticus. The mean age was 48.6 ± 46.5 months. The underlying disorder was epilepsy in 195 cases, and acute symptomatic diseases in 163 (encephalitis or encephalopathy in 88 cases). Midazolam was administered as a bolus dose (0.25 ± 0.21 mg/kg), followed if necessary by continuous infusion (0.26 ± 0.25 mg/kg/hr). The bolus injection was effective in 162 (56.6%) of the 286 cases. In the end, seizure suppression was obtained in 231 cases (64.5% of the total). The effectiveness of midazolam was lower in patients in whom midazolam was initiated more than 3 hours after seizure onset, and this tendency was particularly marked in the epilepsy group. During the treatment period, 10 patients died, but none of these deaths were associated with midazolam therapy. The incidence and types of adverse events were consistent with previously reported data. The present results indicate that midazolam is highly effective for the management of status epilepticus, if used sufficiently early after seizure onset.",

author = "Kitami Hayashi and Makiko Osawa and Masao Aihara and Tatsuro Izumi and Yoko Ohtsuka and Kazuhiro Haginoya and Ikuko Kato and Kenichiro Kaneko and Kenji Sugai and Takao Takahashi and Hamano, {Shin ichiro} and Makoto Matsukura and Hisao Miura and Kimio Minagawa and Tsunekazu Yamano and Hitoshi Yamamoto and Hideo Yamanouchi and Hideto Yoshikawa",

note = "Funding Information: This study was sponsored by the Japanese Ministry of Health, Labor and Welfare to promote Research on Clinical Evidence of Medical Treatment for Status Epilepticus in Childhood (H14-Child-004) within the framework of Clinical Research for Evidenced Based Medicine.",

year = "2007",

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doi = "10.1016/j.pediatrneurol.2007.02.012",

language = "English",

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AU - Hayashi, Kitami

AU - Osawa, Makiko

AU - Aihara, Masao

AU - Izumi, Tatsuro

AU - Ohtsuka, Yoko

AU - Haginoya, Kazuhiro

AU - Kato, Ikuko

AU - Kaneko, Kenichiro

AU - Sugai, Kenji

AU - Takahashi, Takao

AU - Hamano, Shin ichiro

AU - Matsukura, Makoto

AU - Miura, Hisao

AU - Minagawa, Kimio

AU - Yamano, Tsunekazu

AU - Yamamoto, Hitoshi

AU - Yamanouchi, Hideo

AU - Yoshikawa, Hideto

N1 - Funding Information: This study was sponsored by the Japanese Ministry of Health, Labor and Welfare to promote Research on Clinical Evidence of Medical Treatment for Status Epilepticus in Childhood (H14-Child-004) within the framework of Clinical Research for Evidenced Based Medicine.

PY - 2007/6

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N2 - A retrospective multicenter study was conducted, designed to evaluate the efficacy and safety of midazolam for the treatment of status epilepticus. The subjects were 358 inpatients who received intravenous midazolam therapy for status epilepticus. The mean age was 48.6 ± 46.5 months. The underlying disorder was epilepsy in 195 cases, and acute symptomatic diseases in 163 (encephalitis or encephalopathy in 88 cases). Midazolam was administered as a bolus dose (0.25 ± 0.21 mg/kg), followed if necessary by continuous infusion (0.26 ± 0.25 mg/kg/hr). The bolus injection was effective in 162 (56.6%) of the 286 cases. In the end, seizure suppression was obtained in 231 cases (64.5% of the total). The effectiveness of midazolam was lower in patients in whom midazolam was initiated more than 3 hours after seizure onset, and this tendency was particularly marked in the epilepsy group. During the treatment period, 10 patients died, but none of these deaths were associated with midazolam therapy. The incidence and types of adverse events were consistent with previously reported data. The present results indicate that midazolam is highly effective for the management of status epilepticus, if used sufficiently early after seizure onset.

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Efficacy of Intravenous Midazolam for Status Epilepticus in Childhood

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