Midazolam and pentobarbital for refractory status epilepticus

Status epilepticus, a serious, life-threatening emergency characterized by prolonged seizure activity, occurs most commonly in pediatric patients, Alt hough initial therapies with agents such as diazepam, phenytoin, or phenoba rbital generally terminate seizure activity within 30-60 minutes, patients with refractory status epilepticus (RSE) lasting longer require additional intervention, High-dose pentobarbital has been the most commonly prescribed agent for the management of RSE in children; however, midazolam has emerge d as a new treatment option, This review compares the use of midazolam with pentobarbital in published reports of pediatric RSE, Both drugs effectivel y terminated refractory seizure activity, although pentobarbital use was co mplicated by hypotension, delayed recovery, pneumonia, and other adverse ef fects. Midazolam use was effective and well tolerated, affirming its value in pediatric RSE management, (C) 1999 by Elsevier Science Inc, All rights r eserved.