• Critical care medicine · Apr 1992

    Case Reports

    Intravenous midazolam for the treatment of refractory status epilepticus.

    • A Kumar and T P Bleck.
    • Department of Internal Medicine, University of Manitoba Health Sciences Center, Winnipeg, Canada.
    • Crit. Care Med. 1992 Apr 1; 20 (4): 483-8.

    ObjectiveTo determine the usefulness of midazolam as a therapeutic agent for status epilepticus refractory to conventional treatment.DesignRetrospective study.SettingICUs of two university hospitals.PatientsSeven 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.InterventionsIntravenous midazolam by bolus administration followed by infusion.Measurements And Main ResultsMidazolam 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.ConclusionsIn 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.

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