Intravenous midazolam for the treatment of refractory status epilepticus

A. Kumar*, Thomas P Bleck

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

153 Scopus citations

Abstract

Objective: To determine the usefulness of midazolam as a therapeutic agent for status epilepticus refractory to conventional treatment. Design: Retrospective study. Setting: ICUs of two university hospitals. Patients: Seven 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. Interventions: Intravenous midazolam by bolus administration followed by infusion. Measurements and Main Results: Midazolam terminated status epilepticus in all patients in <100 secs, as determined by clinical observation (three patients) or electroencephalographic monitoring (four patients). One patient developed mild hypotension. Conclusions: In 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.

Original languageEnglish (US)
Pages (from-to)483-488
Number of pages6
JournalCritical care medicine
Volume20
Issue number4
DOIs
StatePublished - Jan 1 1992

Keywords

  • anticonvulsant
  • anxiolytic agents
  • barbiturates
  • benzodiazepine
  • epilepsy
  • intensive care unit
  • midazolam
  • neurology
  • seizure
  • status epilepticus

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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