Journal of child neurology
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Clinical Trial
Eight-year study of childhood status epilepticus: midazolam infusion in management and outcome.
Sixty-eight children 2 months to 14 years of age were admitted with status epilepticus to Sultan Qaboos University Hospital from November 1993 to December 2001. Thirty-eight children (55.9%) had refractory status epilepticus and 30 (44.1%) had established status epilepticus. The children with refractory status epilepticus had received intravenous or per rectal diazepam and intravenous phenytoin/phenobarbital (either or both) before continuous infusion of midazolam was given. ⋯ No metabolic derangements or compromise of vital functions was noted on midazolam infusion. All children made a complete recovery. There was one death related to meningoencephalitis.
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Metabolic disorders constitute an important cause of neurologic disease, including infantile epilepsy. The inability to characterize seizures and epilepsy syndromes precisely in infants impedes the recognition of features suggestive of specific underlying metabolic and neurodegenerative etiologies. Classification systems using simple descriptions of ictal behaviors can be reliably applied and may aid in the recognition of these disorders. ⋯ Occasionally, there are distinctive electroencephalographic patterns that may suggest a specific metabolic disease. Earlier recognition of metabolic disorders may be accomplished by careful study of clinical and electrographic characteristics. There are important treatment considerations associated with these disorders.