Efficacy of continuous high dose midazolam infusion in childhood refractory generalized convulsive status epilepticus

ABSTRACT

Prolonged and uncontrolled refractory status epilepticus [SE] is a life-threatening medical emergency in children [1, 2, 3]. There is no consensus on the optimal therapy for refractory status epilepticus [1]. The aim of this study was to develop a new method for treating patients with refractory status epilepticus. Ten children with refractory status epilepticus in Mofid Hospital, who did not respond to 10 microg/kg per min of intravenous midazolam, had their dose of midazolam increased to 30 microg/kg per min. All children were monitored for the development of side effects. Ten children with no response to low-dose midazolam were given a higher dose of midazolam, and 5 [50%] children had a good response. These patients had significantly different response to high-dose midazolam. One patient in the high-dose midazolam group was intubated and required mechanical ventilation. The duration of stay in the hospital and PICU and on mechanical ventilation in patients with no response to low-dose midazolam following with other drugs was longer than in the high-dose midazolam group. No death occurred in high dose midazolam group. High-midazolam dose drip infusion is a safe and effective protocol for refractory status epilepticus in children