ABSTRACT
This prospective randomized study was done in the emergency department at Al-Zahra Hospital [In Madinah] during a period of 12 months [from March 2003 to 2004] on 47 children aged 6 months to 5 years with prolonged febrile seizures [at least 10 minutes]. We aimed at comparing the efficacy and safety of midazolam given intranasal with diazepam given intravenously in the treatment of children with prolonged febrile seizures. The dose of midazolam was 0.2mg/kg intranasal, while the dose of diazepam was 0.3mg/kg intravenously. Overall 23 of 26 seizures were controlled with midazolam, and 24 of 26 with diazepam. The mean time from arrival at hospital to starting treatment was significantly shorter in the midazolam [3.5 [SD1.8] minutes, 95% confidence interval 3.3 to 3.7] than the diazepam group [3.5 [2.0], 5.3 to 5.7]. The mean time to control of seizures was significantly shorter [6.1 [3.6], 6.3 to 6.7] in the midazolam group than in the diazepam group [8 [0.5], 7.9 to 8.3]. No significant side effects were observed in either groups. We conclude that seizures were controlled more quickly with intravenous diazepam than with intranasal midazolam, although midazolam was as safe and effective as diazepam. The overall time to cessation of seizures after arrival at hospital was faster with intranasal midazolam than with intravenous diazepam. The intranasal route can possibly be used not only in medical center, but also in general practice and, with appropriate instruction, families of children with recurrent febrile seizures at home