Intranasal midazolam is as safe and effective as intravenous diazepam in the management of prolonged febrile seizures in children, according to a study published in the British Medical Journal (2000;321:83).
Dr Eli Lahat (Assaf Harofeh medical centre, Israel) and colleagues explain that midazolam given intranasally as an anaesthetic has been shown to be safe and effective in children undergoing various diagnostic and minor surgical procedures. They say that intranasal midazolam suppresses epileptic activity and improves the background of electroencephalograms in children with epilepsy.
In a previous study, the researchers showed that intranasal midazolam was safe and effective for the management of acute seizures in children. In their new, randomised, study, the authors compared the safety and efficacy of intranasal midazolam, 0.2mg/kg, with intravenous diazepam, 0.3mg/kg, in children aged between six months and five years who presented with febrile seizures lasting for at least 10 minutes. They found that the drugs were equally effective at stopping seizures. Twenty-three out of 26 seizures responded to intranasal midazolam, and 24 out of 26 responded to intravenous diazepam.
The researchers conclude that "intranasal midazolam could be provided not only in medical centres but, with appropriate instruction, by the parents at home."