A Kumar1, T P Bleck. 1. Department of Internal Medicine, University of Manitoba Health Sciences Center, Winnipeg, Canada.
Abstract
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.
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 barbituratecoma for the termination of status epilepticus when conventional agents have failed.
Authors: Andres Fernandez; Hector Lantigua; Christine Lesch; Belinda Shao; Brandon Foreman; J Michael Schmidt; Lawrence J Hirsch; Stephan A Mayer; Jan Claassen Journal: Neurology Date: 2013-12-20 Impact factor: 9.910
Authors: Gretchen M Brophy; Rodney Bell; Jan Claassen; Brian Alldredge; Thomas P Bleck; Tracy Glauser; Suzette M Laroche; James J Riviello; Lori Shutter; Michael R Sperling; David M Treiman; Paul M Vespa Journal: Neurocrit Care Date: 2012-08 Impact factor: 3.210