Successful management of refractory neonatal seizures with midazolam

J Child Neurol. 2008 Jun;23(6):706-9. doi: 10.1177/0883073807313041.

Abstract

Seizures are indicative of underlying neurologic dysfunction in neonates. Repeated seizures may be deleterious to the brain even without disturbances of ventilation or perfusion. First-line antiepileptic drugs such as phenobarbital and phenytoin are not very effective in controlling seizures in neonates. Rapid control of status epilepticus with midazolam has been demonstrated in 2 previous studies with complete clinical and electrographic response in neonates who did not respond to phenobarbital and phenytoin. We report our experience with 3 neonates with status epilepticus. Seizures in all 3 neonates did not respond to phenobarbital and phenytoin but responded to midazolam infusion. Midazolam may be considered a safe and effective antiepileptic drug in refractory neonatal seizures of diverse etiologies.

MeSH terms

  • Anticonvulsants / adverse effects
  • Anticonvulsants / therapeutic use
  • Drug Resistance
  • Drug Therapy, Combination
  • Electroencephalography / drug effects
  • Female
  • Humans
  • Hypnotics and Sedatives / adverse effects
  • Hypnotics and Sedatives / therapeutic use*
  • Hypoxia-Ischemia, Brain / complications
  • Infant, Newborn
  • Male
  • Meningitis, Bacterial / complications
  • Midazolam / adverse effects
  • Midazolam / therapeutic use*
  • Status Epilepticus / drug therapy*
  • Status Epilepticus / etiology
  • Streptococcal Infections / complications
  • Streptococcus agalactiae
  • Treatment Outcome

Substances

  • Anticonvulsants
  • Hypnotics and Sedatives
  • Midazolam