Comparison of intranasal midazolam with intravenous diazepam for treating febrile seizures in children: prospective randomised study
Open accessAbstract
OBJECTIVE: To compare the safety and efficacy of midazolam given intranasally with diazepam given intravenously in the treatment of children with prolonged febrile seizures. DESIGN: Prospective randomised study. SETTING: Paediatric emergency department in a general hospital. SUBJECTS: 47 children aged six months to five years with prolonged febrile seizure (at least 10 minutes) during a 12 month period. INTERVENTIONS: Intranasal midazolam (0.2 mg/kg) and intravenous diazepam (0.3 mg/kg). MAIN OUTCOME MEASURES: Time from arrival at hospital to starting treatment and cessation of seizures. RESULTS: Intranasal midazolam and intravenous diazepam were equally effective. Overall, 23 of 26 seizures were controlled with midazolam and 24 out of 26 with diazepam. The mean time from arrival at hospital to starting treatment was significantly shorter in the midazolam group (3.5 (SD 1.8) minutes, 95% confidence interval 3.3 to 3.7) than the diazepam group (5.5 (2.0), 5.3 to 5.7). The mean time to control of seizures was significantly sooner (6.1 (3.6), 6.3 to 6.7) in the midazolam group than the diazepam group (8.0 (0.5), 7. 9 to 8.3). No significant side effects were observed in either group. CONCLUSION: Seizures were controlled more quickly with intravenous diazepam than with intranasal midazolam, although midazolam was as safe and effective as diazepam. The overall time to cessation of seizures after arrival at hospital was faster with intranasal midazolam than with intravenous diazepam. The intranasal route can possibly be used not only in medical centres but in general practice and, with appropriate instructions, by families of children with recurrent febrile seizures at home.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
For children with acute seizures, intranasal midazolam is both safe and effective.
“studies have suggested that intranasal midazolam is safe and effective for acute seizure management in children (124, 127, 128, 135, 136).”
From Benzodiazepines in epilepsy: Pharmacology and pharmacokinetics (2008) · cites this paper as [124]
Open-label studies suggest that intranasal midazolam is safe and effective for acute seizure management in children.
“Open-label studies have suggested that intranasal midazolam is safe and effective for acute seizure management in children (124, 127, 128, 135, 136).”
From Benzodiazepines in epilepsy: Pharmacology and pharmacokinetics (2008) · cites this paper as [124]
Initial treatment response occurred in 23 of 26 seizures (88%) with intranasal midazolam and 24 of 26 (92%) with intravenous diazepam.
“with 88% of seizures (23 of 26) responding to initial treatment with midazolam and 92% (24 of 26) responding to diazepam (124).”
From Benzodiazepines in epilepsy: Pharmacology and pharmacokinetics (2008) · cites this paper as [124]
In three controlled clinical trials, intranasal midazolam had efficacy similar to or better than intravenous or rectal diazepam.
“In three controlled clinical trials, the efficacy of intranasal midazolam was similar to or better than that of i.v. or rectal diazepam (124, 127, 128).”
From Benzodiazepines in epilepsy: Pharmacology and pharmacokinetics (2008) · cites this paper as [124]
A prospective randomized open-label trial found intranasal midazolam comparable to intravenous diazepam in safety and efficacy for febrile seizure management.
“In a prospective, randomized, open-label study, intranasal midazolam was as safe and effective as i.v.diazepam was for managing febrile seizures”
From Benzodiazepines in epilepsy: Pharmacology and pharmacokinetics (2008) · cites this paper as [124]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Protective effect of breast feeding against infection.
Howie, P., Forsyth, J. S., Ogston, S., Clark, A., & Florey, C. D. V. (1990) · BMJ · doi:10.1136/bmj.300.6716.11 · Cited by 877 · see citing works
Midazolam A Review of its Pharmacological Properties and Therapeutic Use
DUNDEE, J. W., Halliday, N. J., Harper, K. W., & Brogden, R. N. (1984) · Drugs · doi:10.2165/00003495-198428060-00002 · Cited by 357 · see citing works
Preanesthetic Sedation of Preschool Children Using Intranasal Midazolam
Wilton, N. C. T., Leigh, J. E., Rosen, D. R., & Pandit, U. A. (1988) · Anesthesiology · doi:10.1097/00000542-198812000-00032 · Cited by 348 · see citing works
A comparison of rectal diazepam gel and placebo for acute repetitive seizures
Dreifuss, F. E., Rosman, N. P., Cloyd, J. C., Pellock, J. M., Kuzniecky, R. I., Lo, W. D., Matsuo, F., Sharp, G. B., Conry, J. A., Bergen, D. C., et al. (1998) · New England Journal of Medicine · doi:10.1056/nejm199806253382602 · Cited by 287 · see citing works
Qualitative study of decisions about infant feeding among women in east end of London
Hoddinott, P., & Pill, R. (1999) · BMJ · doi:10.1136/bmj.318.7175.30 · Cited by 254 · see citing works
A prospective cohort study on breast-feeding and otitis media in Swedish infants
Aniansson, G., Alm, B., ANDERSSON, B., Håkansson, A., LARSSON, P., Nylén, O., PETERSON, H., Rignér, P., Svanborg, M., Sabharwal, H., et al. (1994) · The Pediatric Infectious Disease Journal · doi:10.1097/00006454-199403000-00003 · Cited by 204 · see citing works
Reduced risk of IDDM among breast-fed children. The Colorado IDDM Registry
Mayer, E. J., Hamman, R. F., Gay, E. C., Lezotte, D. C., Savitz, D. A., & KLINGENSMITH, G. J. (1988) · Diabetes · doi:10.2337/diabetes.37.12.1625 · Cited by 187 · see citing works
Chamberlain, J. M., ALTIERI, M. A., Futterman, C., YOUNG, G. M., Ochsenschlager, D. W., & WAISMAN, Y. (1997) · Pediatric Emergency Care · doi:10.1097/00006565-199704000-00002 · Cited by 178 · see citing works
Breastfeeding and the Risk of Sudden Infant Death Syndrome
Ford, R., Taylor, B. J., Mitchell, E., ENRIGHT, S. A., Stewart, A. W., Becroft, D. M. O., Scragg, R. K. R., Hassall, I. B., BARRY, D. M. J., Allen, E. M., et al. (1993) · International Journal of Epidemiology · doi:10.1093/ije/22.5.885 · Cited by 170 · see citing works
Effect of prehospital treatment on the outcome of status epilepticus in children
Alldredge, B. K., Pharm, D., Wall, D. B., & Ferriero, D. M. (1995) · Pediatric Neurology · doi:10.1016/0887-8994(95)00044-g · Cited by 162 · see citing works
Rey, E., Delaunay, L., Pons, G., Murat, I., Richard, M., Saint-Maurice, C., & Olivé, G. (1991) · European Journal of Clinical Pharmacology · doi:10.1007/bf00314967 · Cited by 157 · see citing works
Arendt, R., Greenblatt, D. J., deJong, R. H., Bonin, J. D., Abernethy, D. R., Ehrenberg, B. L., Giles, H. G., Sellers, E. M., & Shader, R. I. (1983) · Journal of Pharmacology and Experimental Therapeutics · doi:10.1016/s0022-3565(25)22081-x · Cited by 151 · see citing works
Lahat, E. (1997) · PubMed · Cited by 141 · see citing works
Self-citationThe human drama of genetics: ‘hard’ and ‘soft’ media representations of inherited breast cancer
Henderson, L., & Kitzinger, J. V. (1999) · Sociology of Health & Illness · doi:10.1111/1467-9566.00173 · Cited by 124 · see citing works
NASAL RATHER THAN RECTAL BENZODIAZEPINES IN THE MANAGEMENT OF ACUTE CHILDHOOD SEIZURES?
‘Regan, M. E. O., Brown, J. K., & Clarke, M. (1996) · Developmental Medicine & Child Neurology · doi:10.1111/j.1469-8749.1996.tb15064.x · Cited by 99 · see citing works
Continuous midazolam infusion as treatment of status epilepticus
Koul, R. L., Aithala, G. R., Chacko, A., Joshi, R., & Elbualy, M. S. (1997) · Archives of Disease in Childhood · doi:10.1136/adc.76.5.445 · Cited by 93 · see citing works
IN VITRO QUANTITATION OF BENZODIAZEPINE LIPOPHILICITY: RELATION TO IN VIVO DISTRIBUTION
Greenblatt, D. J., Arendt, R., Abernethy, D. R., Giles, H. G., Sellers, E. M., & Shader, R. I. (1983) · British Journal of Anaesthesia · doi:10.1093/bja/55.10.985 · Cited by 92 · see citing works
RO 21???3981 for Intravenous Surgical Premedication and Induction of Anesthesia
CONNER, J. T., Katz, R. L., Pagano, R. R., & Graham, C. W. (1978) · Anesthesia & Analgesia · doi:10.1213/00000539-197801000-00001 · Cited by 90 · see citing works
Intermittent Home Treatment of Status and Clusters of Seizures
LOMBROSO, C. T. (1989) · Epilepsia · doi:10.1111/j.1528-1157.1989.tb05819.x · Cited by 74 · see citing works
Media dents confidence in MMR vaccine
Begg, N. T., Ramsay, M. E., White, J. M., & Bozoky, Z. (1998) · BMJ · doi:10.1136/bmj.316.7130.561 · Cited by 72 · see citing works
Midazolam: an effective intravenous agent for seizure control.
GALVIN, G. M., & Jelinek, G. A. (1987) · Archives of emergency medicine · doi:10.1136/emj.4.3.169 · Cited by 65 · see citing works
Nasal midazolam and ketamine for paediatric sedation during computerised tomography
Louon, A., & Reddy, V. G. (1994) · Acta Anaesthesiologica Scandinavica · doi:10.1111/j.1399-6576.1994.tb03885.x · Cited by 65 · see citing works
A pharmacodynamic evaluation of midazolam as an antiepileptic compound.
Jawad, S., Oxley, J. R., Wilson, J. F., & Richens, A. (1986) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp.49.9.1050 · Cited by 64 · see citing works
Intranasal midazolam for childhood seizures
Lahat, E., Goldman, M., Barr, J., Eshel, G., & Berkovitch, M. (1998) · The Lancet · doi:10.1016/s0140-6736(05)79574-x · Cited by 63 · see citing works
Self-citationIntrarectal diazepam in epileptic adults
Remy, C., Jourdil, N., Villemain, D., Favel, P., & Genton, P. (1992) · Epilepsia · doi:10.1111/j.1528-1157.1992.tb02327.x · Cited by 58 · see citing works
Absorption of Diazepam in Man Following Rectal and Parenteral Administration
Magnussen, I., Oxlund, H. R. W., Alsbirk, K. E., & Arnold, E. (1979) · Acta Pharmacologica et Toxicologica · doi:10.1111/j.1600-0773.1979.tb02365.x · Cited by 56 · see citing works
Midazolam in treatment of epileptic seizures
Lahat, E., Aladjem, M., Eshel, G. M., Bistritzer, T., & Katz, Y. (1992) · Pediatric Neurology · doi:10.1016/0887-8994(92)90071-6 · Cited by 55 · see citing works
Self-citationBlack, N. A. (1995) · Europe PMC (PubMed Central) · Cited by 55 · see citing works
Dhillon, S., Oxley, J., & Richens, A. (1982) · British Journal of Clinical Pharmacology · doi:10.1111/j.1365-2125.1982.tb01397.x · Cited by 52 · see citing works
Midazolam nose drops for outpatient echocardiography sedation in infants
Latson, L., Cheatham, J. P., Gumbiner, C. H., Kugler, J. D., Danford, D. A., Hofschire, P. J., & Honts, J. (1991) · American Heart Journal · doi:10.1016/0002-8703(91)90981-m · Cited by 49 · see citing works
Generalized Tonic–Clonic and Febrile Seizures
Hirtz, D. G. (1989) · Pediatric Clinics of North America · doi:10.1016/s0031-3955(16)36654-8 · Cited by 48 · see citing works
The administration of rectal diazepam for acute management of seizures
Seigler, R. S. (1990) · Journal of Emergency Medicine · doi:10.1016/0736-4679(90)90225-k · Cited by 47 · see citing works
Benzodiazepines protect mice from local anesthetic convulsions and deaths.
Jong, R. H. D., & Bonin, J. D. (1981) · PubMed · Cited by 46 · see citing works
Sublingual Lorazepam in Childhood Serial Seizures
Yager, J. Y. (1988) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/archpedi.1988.02150090029016 · Cited by 41 · see citing works
Bioavailability of Rectally Administered Lorazepam
Graves, N. M., Kriel, R. L., & Jones-Saete, C. M. (1987) · Clinical Neuropharmacology · doi:10.1097/00002826-198712000-00007 · Cited by 41 · see citing works
Milligan, N. M., Dhillon, S., Griffiths, A., Oxley, J., & Richens, A. (1984) · Journal of Neurology, Neurosurgery & Psychiatry · doi:10.1136/jnnp.47.3.235 · Cited by 41 · see citing works
The use of midazolam in diagnostic and short surgical procedures in children
Saint-Maurice, C., Landais, A., DELLEUR, M. M., Estève, C., MACGEE, K., & Murat, I. (1990) · Acta Anaesthesiologica Scandinavica · doi:10.1111/j.1399-6576.1990.tb03180.x · Cited by 40 · see citing works
Midazolam in the treatment of epileptic seizures.
Ghilain, S., van Rijckevorsel-Harmant, K., Harmant, J., & de Barsy, T. (1988) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp.51.5.732-a · Cited by 33 · see citing works
Breastfeeding and urinary tract infection
Pisacane, A., Graziano, L., & Zona, G. (1990) · The Lancet · doi:10.1016/0140-6736(90)91559-s · Cited by 29 · see citing works
Continuous infusion of midazolam hydrochloride to control status epilepticus.
Crisp, C. B., Gannon, R., & Knauft, F. (1988) · PubMed · Cited by 24 · see citing works
Policy on cigarette advertising and coverage of smoking and health in European women's magazines.
Amos, A., & Bostock, Y. (1992) · BMJ · doi:10.1136/bmj.304.6819.99 · Cited by 23 · see citing works
Sublingual lorazepam in childhood serial seizures
Knight, N. (1989) · Annals of Emergency Medicine · doi:10.1016/s0196-0644(89)80431-7 · Cited by 18 · see citing works
Nasal rather than Rectal Benzodiazepines in the Management of Acute Childhood Seizures?
Scott, R. C., Neville, B. G. R., Besag, F., & Boyd, S. G. (1997) · Developmental Medicine & Child Neurology · doi:10.1111/j.1469-8749.1997.tb07397.x · Cited by 18 · see citing works
Orebaugh, S. L., & Bradford, S. M. (1994) · The American Journal of Emergency Medicine · doi:10.1016/0735-6757(94)90139-2 · Cited by 13 · see citing works
Flagged first, then by citations
Research works printed but not linked: 2
- Conner JT, Katz RL, Pagano RP, Graham CW. PO21-3981 for intravenous surgical pre-medication and induction of anesthesia. Anesthesiol Anal 1978;57:1-5.
- Lacon A, Reddy VG. Nasal midazolam and ketamine for pediatric seda- tion during computerized tomography. Acta Anesthesiol Scand 1994;38:259-61.
Cited by
Sorted by citations
Guidelines for the Evaluation and Management of Status Epilepticus
Brophy, G. M., BELL, R. D., Claassen, J., Alldredge, B. K., Bleck, T. P., Glauser, T. A., LaRoche, S. M., Riviello, J. J., Shutter, L., Sperling, M. R., et al. (2012) · Neurocritical Care · doi:10.1007/s12028-012-9695-z · Cited by 1,630 · see citing works
Glauser, T. A., Shinnar, S., Gloss, D. S., Alldredge, B. K., Arya, R., Bainbridge, J. L., Bare, M. A., Bleck, T. P., Dodson, W. E., Garrity, L. C., et al. (2016) · Epiliepsy currents/Epilepsy currents · doi:10.5698/1535-7597-16.1.48 · Cited by 1,296 · see citing works
Evaluation of intranasal delivery route of drug administration for brain targeting
Erdő, F., Bors, L. A., Farkas, D., Bajza, Á., & Gizurarson, S. S. (2018) · Brain Research Bulletin · doi:10.1016/j.brainresbull.2018.10.009 · Cited by 756 · see citing works
Benzodiazepines in epilepsy: Pharmacology and pharmacokinetics
Riss, J., Cloyd, J., Gates, J., & Collins, S. (2008) · Acta Neurologica Scandinavica · doi:10.1111/j.1600-0404.2008.01004.x · Cited by 511 · see citing works
Betjemann, J. P., & Lowenstein, D. H. (2015) · The Lancet Neurology · doi:10.1016/s1474-4422(15)00042-3 · Cited by 501 · see citing works
Cognitive-behavioral therapy for psychogenic nonepileptic seizures
Goldstein, L. H., Chalder, T., Chigwedere, C., Khondoker, M. R., Moriarty, J., Toone, B., & Mellers, J. D. C. (2010) · Neurology · doi:10.1212/wnl.0b013e3181e39658 · Cited by 482 · see citing works
McIntyre, J., Robertson, S., Norris, E., Appleton, R., Whitehouse, W. P., Phillips, B., Martland, T., Berry, K., Collier, J., Smith, S., et al. (2005) · The Lancet · doi:10.1016/s0140-6736(05)66909-7 · Cited by 445 · see citing works
(2008) · PEDIATRICS · doi:10.1542/peds.2008-0939 · Cited by 414 · see citing works
McTague, A., Martland, T., & Appleton, R. E. (2018) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd001905.pub3 · Cited by 238 · see citing works
Pharmacotherapy for Status Epilepticus
Trinka, E., Höfler, J., Leitinger, M., & Brigo, F. (2015) · Drugs · doi:10.1007/s40265-015-0454-2 · Cited by 210 · see citing works
Intranasal Medication Delivery for Children: A Brief Review and Update
Wolfe, T. R., & Braude, D. A. (2010) · PEDIATRICS · doi:10.1542/peds.2010-0616 · Cited by 197 · see citing works
McMullan, J. T., Sasson, C., Pancioli, A., & Silbergleit, R. (2010) · Academic Emergency Medicine · doi:10.1111/j.1553-2712.2010.00751.x · Cited by 178 · see citing works
Guidelines for the diagnosis and treatment of acute encephalopathy in childhood
Mizuguchi, M., Ichiyama, T., Imataka, G., Okumura, A., Goto, T., Sakuma, H., Takanashi, J., Murayama, K., Yamagata, T., Yamanouchi, H., et al. (2020) · Brain and Development · doi:10.1016/j.braindev.2020.08.001 · Cited by 171 · see citing works
Knoester, P. D., Jonker, D. M., van der Hoeven, R. T. M., Vermeij, T. A. C., Edelbroek, P. M., Brekelmans, G. J. F., & de Haan, G. (2002) · British Journal of Clinical Pharmacology · doi:10.1046/j.1365-2125.2002.01588.x · Cited by 156 · see citing works
Holsti, M., Dudley, N. C., Schunk, J. E., Adelgais, K., Greenberg, R., Olsen, C. S., Healy, A. H., Firth, S. D., & Filloux, F. M. (2010) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/archpediatrics.2010.130 · Cited by 154 · see citing works
Intranasal midazolam vs rectal diazepam in acute childhood seizures
Bhattacharyya, M., Kalra, V., & Gulati, S. (2006) · Pediatric Neurology · doi:10.1016/j.pediatrneurol.2005.09.006 · Cited by 152 · see citing works
The Epidemiology of Convulsive Status Epilepticus in Children: A Critical Review
Raspall‐Chaure, M., Chin, R., Neville, B. G. R., Bedford, H. E., & Scott, R. C. (2007) · Epilepsia · doi:10.1111/j.1528-1167.2007.01175.x · Cited by 146 · see citing works
Kienitz, R., Kay, L., Beuchat, I., Gelhard, S., von Brauchitsch, S., Mann, C., Lucaciu, A., Schäfer, J.-H., Siebenbrodt, K., Zöllner, J.-P., et al. (2022) · CNS Drugs · doi:10.1007/s40263-022-00940-2 · Cited by 139 · see citing works
Fişgin, T., Gurer, Y., Tezic, T., Senbil, N., Zorlu, P., Okuyaz, C., & Akgün, D. (2002) · Journal of Child Neurology · doi:10.1177/088307380201700206 · Cited by 138 · see citing works
Barton, E. D., Colwell, C. B., Wolfe, T. R., Fosnocht, D., Gravitz, C. S., Bryan, T. S., Dunn, W., Benson, J., & Bailey, J. E. (2005) · Journal of Emergency Medicine · doi:10.1016/j.jemermed.2005.03.007 · Cited by 136 · see citing works
Haut, S. R. (2015) · Current Opinion in Neurology · doi:10.1097/wco.0000000000000177 · Cited by 134 · see citing works
Prophylactic drug management for febrile seizures in children
Offringa, M., Newton, R., Cozijnsen, M. A., & Nevitt, S. J. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003031.pub3 · Cited by 115 · see citing works
Trends in Status Epilepticus—Related Hospitalizations and Mortality
Betjemann, J. P., Josephson, S. A., Lowenstein, D. H., & Burke, J. F. (2015) · JAMA Neurology · doi:10.1001/jamaneurol.2015.0188 · Cited by 113 · see citing works
Prehospital Intranasal Midazolam for the Treatment of Pediatric Seizures
Holsti, M., Sill, B. L., Firth, S. D., Filloux, F. M., Joyce, S. M., & Furnival, R. A. (2007) · Pediatric Emergency Care · doi:10.1097/pec.0b013e3180328c92 · Cited by 110 · see citing works
Detyniecki, K., Ess, P. J. V., Sequeira, D. J., Wheless, J. W., Meng, T., & Pullman, W. E. (2019) · Epilepsia · doi:10.1111/epi.15159 · Cited by 108 · see citing works
Intranasal Delivery of Antiepileptic Medications for Treatment of Seizures
Wermeling, D. P. (2009) · Neurotherapeutics · doi:10.1016/j.nurt.2009.01.002 · Cited by 104 · see citing works
Clinical Pharmacology of Midazolam in Neonates and Children: Effect of Disease—A Review
Pacifici, G. M. (2014) · International Journal of Pediatrics · doi:10.1155/2014/309342 · Cited by 104 · see citing works
Brigo, F., Nardone, R., Tezzon, F., & Trinka, E. (2015) · Epilepsy & Behavior · doi:10.1016/j.yebeh.2015.02.030 · Cited by 96 · see citing works
Why won’t it stop? The dynamics of benzodiazepine resistance in status epilepticus
Burman, R. J., Rosch, R. E., Wilmshurst, J. M., Sen, A., Ramantani, G., Akerman, C. J., & Raimondo, J. V. (2022) · Nature Reviews Neurology · doi:10.1038/s41582-022-00664-3 · Cited by 96 · see citing works
Appleton, R. E., Macleod, S., & Martland, T. (2008) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd001905.pub2 · Cited by 96 · see citing works
Basu, S., & Bandyopadhyay, A. K. (2010) · AAPS PharmSciTech · doi:10.1208/s12249-010-9477-x · Cited by 91 · see citing works
Corrigan, M., Wilson, S. S., & Hampton, J. P. (2015) · American Journal of Health-System Pharmacy · doi:10.2146/ajhp140630 · Cited by 89 · see citing works
Rech, M. A., Barbas, B., Chaney, W., Greenhalgh, E., & Turck, C. J. (2017) · Annals of Emergency Medicine · doi:10.1016/j.annemergmed.2017.02.015 · Cited by 89 · see citing works
Current oral and non-oral routes of antiepileptic drug delivery
Anderson, G. D., & Saneto, R. P. (2012) · Advanced Drug Delivery Reviews · doi:10.1016/j.addr.2012.01.017 · Cited by 85 · see citing works
Intranasal Medications in Pediatric Emergency Medicine
Pizzo, J. D., & Callahan, J. M. (2014) · Pediatric Emergency Care · doi:10.1097/pec.0000000000000171 · Cited by 84 · see citing works
The mortality and morbidity of febrile seizures
Chungath, M., & Shorvon, S. D. (2008) · Nature Clinical Practice Neurology · doi:10.1038/ncpneuro0922 · Cited by 83 · see citing works
The Pathogenesis of Fever-Induced Febrile Seizures and Its Current State
Mosili, P., Maikoo, S., Mabandla, M. V., & Qulu, L. (2020) · Neuroscience Insights · doi:10.1177/2633105520956973 · Cited by 79 · see citing works
Capovilla, G., Beccaria, F., Beghi, E., Minicucci, F., Sartori, S., & Vecchi, M. (2013) · Epilepsia · doi:10.1111/epi.12307 · Cited by 79 · see citing works
Talukdar, B., & Chakrabarty, B. (2008) · Brain and Development · doi:10.1016/j.braindev.2008.11.006 · Cited by 75 · see citing works
Welch, R. D., Nicholas, K. S., Durkalski‐Mauldin, V. L., Lowenstein, D. H., CONWIT, R. A., Mahajan, P., Lewandowski, C., Silbergleit, R., & the Neurological Emergencies Treatment Trials (NETT) Network Investigators (2015) · Epilepsia · doi:10.1111/epi.12905 · Cited by 74 · see citing works
Tanabe, T., Awaya, Y., Matsuishi, T., Iyoda, K., Nagai, T., Kurihara, M., Yamamoto, K., Minagawa, K., & Maekawa, K. (2008) · Brain and Development · doi:10.1016/j.braindev.2008.03.002 · Cited by 73 · see citing works
Ashrafi, M. R., Khosroshahi, N., Karimi, P., Malamiri, R. A., Bavarian, B., Zarch, A. V., Mirzaei, M., & Kompani, F. (2010) · European Journal of Paediatric Neurology · doi:10.1016/j.ejpn.2010.05.009 · Cited by 72 · see citing works
Benzodiazepine use in seizure emergencies: A systematic review
Haut, S. R., Seinfeld, S. A., & Pellock, J. M. (2016) · Epilepsy & Behavior · doi:10.1016/j.yebeh.2016.07.018 · Cited by 70 · see citing works
Thakker, A., & Shanbag, P. (2012) · Journal of Neurology · doi:10.1007/s00415-012-6659-3 · Cited by 69 · see citing works
Charalambous, M., Bhatti, S. F. M., Ham, L. V., Platt, S. R., Jeffery, N. D., Tipold, A., Siedenburg, J. S., Volk, H. A., Hasegawa, D., Gallucci, A., et al. (2017) · Journal of Veterinary Internal Medicine · doi:10.1111/jvim.14734 · Cited by 68 · see citing works
Use of intranasal midazolam to treat acute seizures in paediatric community settings
Harbord, M. G., Kyrkou, N., Kyrkou, M. R., Kay, D., & Coulthard, K. (2004) · Journal of Paediatrics and Child Health · doi:10.1111/j.1440-1754.2004.00463.x · Cited by 68 · see citing works
Intranasal drug delivery: An alternative to intravenous administration in selected emergency cases
Wolfe, T. R., & Bernstone, T. (2004) · Journal of Emergency Nursing · doi:10.1016/j.jen.2004.01.006 · Cited by 67 · see citing works
Efficacy of nonvenous medications for acute convulsive seizures
Arya, R., Kothari, H., Zhang, Z., Han, B., Horn, P. S., & Glauser, T. A. (2015) · Neurology · doi:10.1212/wnl.0000000000002142 · Cited by 67 · see citing works
Sreenath, T. G., Gupta, P., Sharma, K. K., & Krishnamurthy, S. (2009) · European Journal of Paediatric Neurology · doi:10.1016/j.ejpn.2009.02.004 · Cited by 64 · see citing works
Management of Prolonged Seizures and Status Epilepticus in Childhood: A Systematic Review
Sofou, K., Kristjánsdóttir, R., Papachatzakis, N. E., Ahmadzadeh, A., & Uvebrant, P. (2009) · Journal of Child Neurology · doi:10.1177/0883073809332768 · Cited by 63 · see citing works
Intranasal midazolam therapy for pediatric status epilepticus
Wolfe, T. R., & Macfarlane, T. C. (2006) · The American Journal of Emergency Medicine · doi:10.1016/j.ajem.2005.11.004 · Cited by 63 · see citing works
An Evidence-based Guideline for Pediatric Prehospital Seizure Management Using GRADE Methodology
Shah, M. I., Macias, C. G., Dayan, P. S., Weik, T. S., Brown, K., Fuchs, S. M., Fallat, M. E., Wright, J. L., & Lang, E. (2013) · Prehospital Emergency Care · doi:10.3109/10903127.2013.844874 · Cited by 62 · see citing works
Prehospital midazolam use and outcomes among patients with out-of-hospital status epilepticus
Guterman, E. L., Sanford, J. K., Betjemann, J. P., Zhang, L., Burke, J. F., Lowenstein, D. H., Josephson, S. A., & Sporer, K. A. (2020) · Neurology · doi:10.1212/wnl.0000000000010913 · Cited by 61 · see citing works
Prehospital Care for the Adult and Pediatric Seizure Patient: Current Evidence-based Recommendations
Silverman, E. C., Sporer, K. A., Lemieux, J. M., Brown, J. F., Koenig, K. L., Gausche‐Hill, M., Rudnick, E., Salvucci, A., & Gilbert, G. H. (2017) · Western Journal of Emergency Medicine · doi:10.5811/westjem.2016.12.32066 · Cited by 60 · see citing works
Status Epilepticus: Clinical Analysis of a Treatment Protocol Based on Midazolam and Phenytoin
Brevoord, J. C. D., Joosten, K. F. M., ARTS, W. F. M., van Rooij, R. W., & de Hoog, M. (2005) · Journal of Child Neurology · doi:10.1177/088307380502000602 · Cited by 59 · see citing works
Intranasal therapies for acute seizures
Kälviäinen, R. K. (2015) · Epilepsy & Behavior · doi:10.1016/j.yebeh.2015.04.027 · Cited by 58 · see citing works
Recent advances in status epilepticus
Trinka, E., Brigo, F., & Shorvon, S. D. (2016) · Current Opinion in Neurology · doi:10.1097/wco.0000000000000307 · Cited by 58 · see citing works
Cloyd, J. C., Haut, S. R., Carrazana, E. J., & Rabinowicz, A. L. (2021) · Epilepsia · doi:10.1111/epi.16847 · Cited by 57 · see citing works
Pediatric Intensive Care Treatment of Uncontrolled Status Epilepticus
Wilkes, R., & Tasker, R. C. (2013) · Critical Care Clinics · doi:10.1016/j.ccc.2012.11.007 · Cited by 57 · see citing works
Leung, A. K. C., & Robson, W. L. M. (2007) · Journal of Pediatric Health Care · doi:10.1016/j.pedhc.2006.10.006 · Cited by 57 · see citing works
Pharmacokinetics and pharmacodynamics of nasally delivered midazolam
Haschke, M., Suter, K., Hofmann, S., Witschi, R., Froehlich, J. M., Imanidis, G., Drewe, J., Briellmann, T., Dussy, F. E., Krähenbühl, S., et al. (2010) · British Journal of Clinical Pharmacology · doi:10.1111/j.1365-2125.2010.03611.x · Cited by 56 · see citing works
Primary Air–Liquid Interface Culture of Nasal Epithelium for Nasal Drug Delivery
Ong, H. X., Jackson, C. L., Cole, J. L., Lackie, P. M., Traini, D., Young, P. M., Lucas, J. S., & Conway, J. H. (2016) · Molecular Pharmaceutics · doi:10.1021/acs.molpharmaceut.5b00852 · Cited by 54 · see citing works
Rapid-onset intranasal delivery of metoclopramide hydrochloride
Zaki, N. M., Mortada, N. D., Awad, G. A. S., & ElHady, S. S. A. (2006) · International Journal of Pharmaceutics · doi:10.1016/j.ijpharm.2006.07.038 · Cited by 52 · see citing works
Intranasal naloxone for the treatment of suspected heroin overdose
Kerr, D., Dietze, P., & Kelly, A. (2008) · Addiction · doi:10.1111/j.1360-0443.2007.02097.x · Cited by 51 · see citing works
Buccal midazolam for treatment of prolonged seizures in children
Kutlu, N. O., Doğrul, M., Yakıncı, C., & Soylu, H. (2003) · Brain and Development · doi:10.1016/s0387-7604(02)00230-9 · Cited by 51 · see citing works
Inhaled alprazolam rapidly suppresses epileptic activity in photosensitive participants
French, J. A., Wechsler, R. T., Gelfand, M. A., Pollard, J. R., Vázquez, B., Friedman, D. J., Gong, L. H., Kamemoto, E. S., Isojärvi, J. I. T., & Cassella, J. V. (2019) · Epilepsia · doi:10.1111/epi.16279 · Cited by 50 · see citing works
Wheless, J. W., Meng, T., Ess, P. J. V., Detyniecki, K., Sequeira, D. J., & Pullman, W. E. (2019) · Epilepsia · doi:10.1111/epi.16300 · Cited by 49 · see citing works
Seizure clusters, rescue treatments, seizure action plans: Unmet needs and emerging formulations
Gidal, B. E., Klein, P., & Hirsch, L. J. (2020) · Epilepsy & Behavior · doi:10.1016/j.yebeh.2020.107391 · Cited by 47 · see citing works
Mittal, P., Manohar, R., & Rawat, A. (2006) · The Indian Journal of Pediatrics · doi:10.1007/bf02758299 · Cited by 47 · see citing works
Emergency Treatment of Status Epilepticus: Current Thinking
Millikan, D., Rice, B. T., & Silbergleit, R. (2009) · Emergency Medicine Clinics of North America · doi:10.1016/j.emc.2008.12.001 · Cited by 46 · see citing works
Medical Treatment of Pediatric Status Epilepticus
Abend, N. S., Gutierrez‐Colina, A. M., & Dlugos, D. (2010) · Seminars in Pediatric Neurology · doi:10.1016/j.spen.2010.06.005 · Cited by 46 · see citing works
Brigo, F., Nardone, R., Tezzon, F., & Trinka, E. (2015) · CNS Drugs · doi:10.1007/s40263-015-0271-x · Cited by 45 · see citing works
Zhao, Z., Wang, H., Wen, B., Yang, Z., Feng, K., & Fan, J. (2016) · Journal of Child Neurology · doi:10.1177/0883073816638757 · Cited by 45 · see citing works
Treatment of Status Epilepticus
Haider, H. A., & Hirsch, L. J. (2008) · Seminars in Neurology · doi:10.1055/s-2008-1079339 · Cited by 45 · see citing works
Established and emerging GABAA receptor pharmacotherapy for epilepsy
Richardson, R. J., Petrou, S., & Bryson, A. (2024) · Frontiers in Pharmacology · doi:10.3389/fphar.2024.1341472 · Cited by 44 · see citing works
Wermeling, D. P., Record, K. E., Archer, S. M., & Rudy, A. C. (2008) · Epilepsy Research · doi:10.1016/j.eplepsyres.2008.10.005 · Cited by 44 · see citing works
Prophylactic drug management for febrile seizures in children
Offringa, M., & Newton, R. (2012) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003031.pub2 · Cited by 44 · see citing works
Treatment of epilepsy existing therapies and future developments
Aiken, S. P. (2000) · Frontiers in bioscience · doi:10.2741/aiken · Cited by 43 · see citing works
Diazepam pharmacokinetics after nasal drop and atomized nasal administration in dogs
Musulin, S. E., Mariani, C. L., & Papich, M. G. (2010) · Journal of Veterinary Pharmacology and Therapeutics · doi:10.1111/j.1365-2885.2010.01186.x · Cited by 42 · see citing works
Chhabra, R., Gupta, R., & Gupta, L. K. (2021) · Epilepsy & Behavior · doi:10.1016/j.yebeh.2021.108390 · Cited by 42 · see citing works
Prophylactic drug management for febrile seizures in children
Offringa, M., Newton, R., Nevitt, S. J., & Vraka, K. (2021) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003031.pub4 · Cited by 42 · see citing works
Antiepileptic drug treatment in the end-of-life phase of glioma patients: a feasibility study
Koekkoek, J. A. F., Postma, T. J., Heimans, J. J., Reijneveld, J. C., & TAPHOORN, M. J. B. (2015) · Supportive Care in Cancer · doi:10.1007/s00520-015-2930-3 · Cited by 41 · see citing works
Controlling seizures in the prehospital setting: Diazepam or midazolam?
Rainbow, J., Browne, G., & Lam, L. T.-M. (2002) · Journal of Paediatrics and Child Health · doi:10.1046/j.1440-1754.2002.00046.x · Cited by 40 · see citing works
Rescue therapies for seizure clusters: Pharmacology and target of treatments
Gidal, B. E., & Detyniecki, K. (2022) · Epilepsia · doi:10.1111/epi.17341 · Cited by 39 · see citing works
Feasibility study of a caregiver seizure alert system in canine epilepsy
Coles, L. D., Patterson, E. E., Sheffield, W. D., Mavoori, J., Higgins, J., Michael, B., Leyde, K. W., Cloyd, J. C., Litt, B., Vite, C. H., et al. (2013) · Epilepsy Research · doi:10.1016/j.eplepsyres.2013.06.007 · Cited by 38 · see citing works
The current state of treatment of status epilepticus
Hirsch, L. J., & Claassen, J. (2002) · Current Neurology and Neuroscience Reports · doi:10.1007/s11910-002-0010-9 · Cited by 38 · see citing works
Use of Emergency Medication in Adult Patients with Epilepsy: A Multicentre Cohort Study from Germany
Kadel, J., Bauer, S., Hermsen, A., Immisch, I., Kay, L., Klein, K. M., Knake, S., Menzler, K., Reif, P. S., Rosenow, F., et al. (2018) · CNS Drugs · doi:10.1007/s40263-018-0544-2 · Cited by 38 · see citing works
Charalambous, M., Muñana, K. R., Patterson, E. E., Platt, S. R., & Volk, H. A. (2023) · Journal of Veterinary Internal Medicine · doi:10.1111/jvim.16928 · Cited by 37 · see citing works
Acute Drug Administration in Epilepsy: A Review
Wolf, P. (2010) · CNS Neuroscience & Therapeutics · doi:10.1111/j.1755-5949.2010.00167.x · Cited by 37 · see citing works
Kay, L., Merkel, N. B., von Blomberg, A., Willems, L. M., Bauer, S., Reif, P. S., Schubert‐Bast, S., Rosenow, F., & Strzelczyk, A. (2019) · Annals of Clinical and Translational Neurology · doi:10.1002/acn3.50932 · Cited by 37 · see citing works
Status Epilepticus and Acute Serial Seizures in Children
Mitchell, W. G. (2002) · Journal of Child Neurology · doi:10.1177/08830738020170010501 · Cited by 37 · see citing works
Bioavailability of a novel midazolam gel after intranasal administration in dogs
Eagleson, J. S., Platt, S. R., Strong, D. L., Kent, M., Freeman, A., Nghiem, P. P., Zheng, B., & White, C. A. (2012) · American Journal of Veterinary Research · doi:10.2460/ajvr.73.4.539 · Cited by 36 · see citing works
Epilepsy in the end of life phase of brain tumor patients: a systematic review
Koekkoek, J. A. F., Dirven, L., Reijneveld, J. C., Postma, T. J., Grant, R., Pace, A., Oberndorfer, S., Heimans, J. J., & TAPHOORN, M. J. B. (2014) · Neuro-Oncology Practice · doi:10.1093/nop/npu018 · Cited by 36 · see citing works
Kay, L., Reif, P. S., Belke, M., Bauer, S., Fründ, D., Knake, S., Rosenow, F., & Strzelczyk, A. (2015) · Epilepsia · doi:10.1111/epi.13088 · Cited by 34 · see citing works
Treatment of convulsive and nonconvulsive status epilepticus
Pang, T. D., & Hirsch, L. J. (2005) · Current Treatment Options in Neurology · doi:10.1007/s11940-005-0035-x · Cited by 34 · see citing works
Emergency management of the paediatric patient with convulsive status epilepticus
McKenzie, K. C., Hahn, C. D., & Friedman, J. (2021) · Paediatrics & Child Health · doi:10.1093/pch/pxaa127 · Cited by 33 · see citing works
Charalambous, M., Volk, H. A., Ham, L. V., & Bhatti, S. F. M. (2021) · BMC Veterinary Research · doi:10.1186/s12917-021-02805-0 · Cited by 32 · see citing works
Tsze, D. S., Lubell, T. R., Carter, R., Chernick, L. S., DePeter, K. C., McLaren, S. H., Kwok, M. Y., Roskind, C. G., Gonzalez, A. E., Fan, W., et al. (2021) · Academic Emergency Medicine · doi:10.1111/acem.14422 · Cited by 32 · see citing works
Bancke, L. L., Dworak, H., Rodvold, K. A., Halvorsen, M. B., & Gidal, B. E. (2015) · Epilepsia · doi:10.1111/epi.13131 · Cited by 32 · see citing works
Alshehri, A. A., Abulaban, A. A., Bokhari, R. F. Y., Kojan, S. M., Alsalamah, M. A., Ferwana, M. S., & Murad, M. H. (2017) · Academic Emergency Medicine · doi:10.1111/acem.13190 · Cited by 31 · see citing works
- Authors
- Lahat, E.
- Affiliations
- Assaf Harofeh Medical Center (IL)
- Corresponding author
- Lahat, E.
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2000-07-08
- Volume
- 321
- Issue
- 7253
- Pages
- 83-86
- ISSN
- 0959-8138 (ISSN-L)
- PMC
- PMC27427
- OpenAlex
- W2059085344
- Cited by
- 294
- References
- 46
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 6 · 2023: 8 · 2022: 13 · 2021: 11 · 2020: 15 · 2019: 9 · 2018: 8 · 2017: 14 · 2016: 12 · 2015: 25 · 2014: 21 · 2013: 13 · 2012: 11
- FWCI
- 4.65
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- BMJ (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Epilepsy research and treatment
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Anesthesia and Sedative Agents
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pharmaceutical studies and practices
- Keywords
- febrile seizures, prolonged febrile seizures, intranasal midazolam, intravenous diazepam, benzodiazepines, seizure control, pediatric emergency care, time to treatment, children
- MeSH terms
- Administration, Intranasal, Anticonvulsants, Child, Child, Preschool, Seizures, Febrile, Diazepam, Female, Humans, Infant, Infusions, Intravenous, Male, Midazolam, Prospective Studies, Treatment Outcome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
