Intranasal Midazolam Versus Intravenous Diazepam for the Treatment of Acute Seizures in Paediatric Patients

The objective of this study was to measure the time needed to control seizure attacks using intranasal midazolam compared with intravenous diazepam and to evaluate the probable side effects. This study was conducted as a non blind randomized clinical trial among 50 patients coming to MLBMC, Jhansi. The patients were 2 months to 15 years old children coming to our emergency department suffering from an acute seizure episode. Intranasal midazolam was administered 0.2 mg/kg equally dropped in both nostrils for group A and intravenous diazepam was administered 0.3mg/kg via intravenous line for group B. Choice of drugs for patient was based on randomization. After both treatments, the time needed to control the seizure was registered by the practitioner. Pulse rate and oxygen saturation were recorded at patient's entrance and in minutes 5 and 10 after drug administration. The mean time from physician contact to cessation of seizures was significantly shorter in the midazolam group (3.9880(SD 1.38784) minutes), than the diazepam group (5.4840 (SD 2.33661)min). The mean time from drug administration to cessation of seizures was significantly sooner (3.1160 (SD 0.97112)min) in the diazepam group than the midazolam group (3.8720 (SD 1.57229) min). No significant side effects were observed in either group. 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 due to its shorter time of adminstration