Midazolam in the treatment of refractory neonatal seizures.

Abstract:

:Midazolam, a potent short-acting benzodiazepine, is a safe and highly effective agent for the control of status epilepticus. Its efficacy in the control of neonatal seizures, however, has not been determined. Six neonates (aged 1-9 days; gestation, 30-41 weeks) developed seizures from a variety of causes. In each case, seizures persisted for > 12 h despite high-dose phenobarbital therapy with or without the addition of phenytoin. Midazolam was then administered by continuous intravenous infusion (0.1-0.4 mg/kg/h) for 1 to 3 days. Within 1 h of initiation of midazolam, seizures were controlled in all six neonates. Electroencephalographic seizures were abolished in four of six neonates; however, two neonates continued to have electrographic seizures (without clinical accompaniment) for a further 12 h. Blood pressure and pulse rate were not changed after the initiation of midazolam, and adverse reactions were not observed in any neonate. Because more than one third of all neonatal seizures are refractory to high-dose phenobarbital and phenytoin, midazolam administered by continuous intravenous infusion may be a valuable adjunctive therapy.

journal_name

Clin Neuropharmacol

authors

Sheth RD,Buckley DJ,Gutierrez AR,Gingold M,Bodensteiner JB,Penney S

doi

10.1097/00002826-199619020-00005

subject

Has Abstract

pub_date

1996-04-01 00:00:00

pages

165-70

issue

2

eissn

0362-5664

issn

1537-162X

journal_volume

19

pub_type

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