• D Galdames-Contreras, E Carrasco-Poblete, L Aguilera-Olivares, L Fabres-Oyarzo, and D Galdames-Poblete.
• Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago de Chile, Chile.
• Rev Neurol. 2006 Mar 16;42(6):332-5.

IntroductionThe status epilepticus a serious complication of the epileptic syndrome with high rates of morbidity and mortality. Treatment is aimed to a fast control of the crisis.AimTo evaluate the efficacy and security of intramuscular (IM) midazolam in the initial treatment of status epilepticus.Patients And MethodsA prospective open clinical trial that included 43 status epilepticus in 38 adult patients. All of the cases received an initial dose of 15 mg IM of midazolam, with a simultaneous oral dose of phenytoin (15 to 20 mg/kg) or carbamazepine (15 mg/kg). If there was immediate control of the seizure but recurrence occurred during the next hours, 15 mg im of midazolam every 8 hours were given, for 24 hours. If there was immediate failure intravenous (IV) midazolam was given.Results36 of the 43 status epilepticus were controlled: 30 with only one dose, 3 required additional IM doses, and 3 needed administration of IV midazolam, no patient had neither cardiovascular, respiratory or local complications. The only adverse effect was drowsiness in a variable grade.ConclusionsThe use of IM midazolam is suggested as the initial treatment in status epilepticus in adults, especially in a low complexity setting, due to its effectiveness, quick action and security.

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