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CASE REPORTS
JOURNAL ARTICLE
RESEARCH SUPPORT, NON-U.S. GOV'T
Intravenous midazolam for the treatment of refractory status epilepticus.
Critical Care Medicine 1992 April
OBJECTIVE: To determine the usefulness of midazolam as a therapeutic agent for status epilepticus refractory to conventional treatment.
DESIGN: Retrospective study.
SETTING: ICUs of two university hospitals.
PATIENTS: Seven patients with refractory status epilepticus who failed treatment with diazepam, lorazepam, and phenytoin, with or without phenobarbital. All patients received mechanical ventilation before receiving midazolam.
INTERVENTIONS: Intravenous midazolam by bolus administration followed by infusion.
MEASUREMENTS AND MAIN RESULTS: Midazolam terminated status epilepticus in all patients in less than 100 secs, as determined by clinical observation (three patients) or electroencephalographic monitoring (four patients). One patient developed mild hypotension.
CONCLUSIONS: In this small study, midazolam appears to be an effective and safe alternative to high-dose barbiturate coma for the termination of status epilepticus when conventional agents have failed.
DESIGN: Retrospective study.
SETTING: ICUs of two university hospitals.
PATIENTS: Seven patients with refractory status epilepticus who failed treatment with diazepam, lorazepam, and phenytoin, with or without phenobarbital. All patients received mechanical ventilation before receiving midazolam.
INTERVENTIONS: Intravenous midazolam by bolus administration followed by infusion.
MEASUREMENTS AND MAIN RESULTS: Midazolam terminated status epilepticus in all patients in less than 100 secs, as determined by clinical observation (three patients) or electroencephalographic monitoring (four patients). One patient developed mild hypotension.
CONCLUSIONS: In this small study, midazolam appears to be an effective and safe alternative to high-dose barbiturate coma for the termination of status epilepticus when conventional agents have failed.
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