INTRAVENOUS MIDAZOLAM FOR THE TREATMENT O F STATUS EPILEPTICUS IN CHILDREN

Background. - Status epilepticus is usually treated by benzodiazepines such as diazepam or clonazepam in association with phenytoin and phen obarbital. Midazolam (MDZ) is a recently developed short-elimination h alf-life benzodiazepine.Case reports. - Four children, aged 3 days to 4 years, were hospitalized in the pediatric intensive care unit for li fe-threatening illness and developed status epilepticus. They were giv en an iv bolus dose of 300 to 500 mu g/kg of MDZ immediately followed by a continuous iv infusion at the dose of 100 to 300 mu g/kg/h. All s eizures stopped within I hour after the bolus dose administration. No acute adverse events of MDZ were noted. Withdrawal symptoms in one pat ient were controlled by progressive reduction of MDZ doses. Neurologic sequelae were noted in three children, secondary to their primitive i llness. Conclusions. - High doses of MDZ are effective for treating re fractory status epilepticus; optimal dosage and duration of treatment remains to be determined.