Comparison of Intravenous Midazolam Drip with Intermittent Intravenous Diazepam in the Treatment of Refractory Serial Seizures in Children

OBJECTIVE: Serial seizures occur commonly in inpatient epileptic children. This type of seizure due to its characteristics has a significant impact on the patient’s health. Untreated serial seizures lead to status epilepticus; therefore, finding a more effective treatment for such patients is essential. This study was performed to compare the outcome of intermittent intravenous diazepam in the pediatric neurology clinic and intravenous midazolam in the pediatric intensive care unit (PICU), in order to introduce an alternative treatment for serail seizures. MATERIALS & METHODS: In this study, 38 inpatient children aged 6 mo-15 years with refractory serial seizures were treated by first line antiepileptic drugs and then randomly treated with either intermittent intravenous diazepam in the neurology ward or intravenous midazolam in PICU. RESULTS: Fourteen (70%) diazepam group patients and 13 (72.2%) midazolam group patients had good response to treatment, there was no significant difference between the two groups. Four midazolam group patients and two diazepam group patients needed mechanical ventilation and were intubated during treatment, with no significant difference between the two groups. Durations of mechanical ventilation and PICU and hospital stay were not significantly different between the two groups. CONCLUSION: Intermittent intravenous diazepam is an effective alternative therapy for midazolam drip in the treatment of serial seizures due to similar therapeutic effects and fewer side effects.