A Comparison of Midazolam, Lorazepam, and Diazepam for the Treatment of Status Epilepticus in Children

@article{Zhao2016ACO,
  title={A Comparison of Midazolam, Lorazepam, and Diazepam for the Treatment of Status Epilepticus in Children},
  author={Ziyu Zhao and Hong-ying Wang and Bin Wen and Zhi-bo Yang and K Feng and Jing-chun Fan},
  journal={Journal of Child Neurology},
  year={2016},
  volume={31},
  pages={1093 - 1107}
}
Midazolam, lorazepam, and diazepam were recommended as emergent initial therapy for status epilepticus. However, there are no current studies to confirm the best agent for pediatric status epilepticus. We compared the efficacy of midazolam, lorazepam, and diazepam in treating pediatric status epilepticus using a network meta-analysis method. In total, 16 randomized controlled trials containing 1821 patients were included. Nonintravenous midazolam, intravenous lorazepam, and intravenous diazepam… 
Comparing the effectiveness of intranasal Midazolam and intravenous Lorazepam for the treatment of acute seizures in children
Objective: The objective of this study was to compare the safety and efficacy of intranasal midazolam with intravenous lorazepam in acute seizures in children. Methods: Children aged 6 months–12
Efficacy, safety, and pharmacokinetics of intravenous midazolam in Japanese children with status epilepticus
TLDR
The efficacy and safety of midazolam were demonstrated in children with status epilepticus, suggesting that intravenous midazlam is suitable as first-line treatment.
An update in the initial management of paediatric status epilepticus
TLDR
Benzodiazepines remain the first-line agent of choice, although there is ongoing discussion about the mode of administration and the best drug to choose.
Healthcare Utilization Characteristics for Intranasal Midazolam Versus Rectal Diazepam
TLDR
The results substantiate the cost-effective benefits of prescribing intranasal midazolam compared to per rectum diazepam because several aspects of health care utilization were decreased in those using intran asal midrazolam.
Pharmacotherapy for Pediatric Convulsive Status Epilepticus
TLDR
A potential therapeutic approach for future studies may entail consideration of interventions that may accelerate diagnosis and treatment of SE, as well as rational and early polytherapy based on synergism between ASMs by utilizing medications targeting different mechanisms of epileptogenesis and epileptogenicity.
A Phase 3 open-label study of the efficacy, safety and pharmacokinetics of buccally administered midazolam hydrochloride for the treatment of status epilepticus in pediatric Japanese subjects
TLDR
The efficacy, safety and pharmacokinetic profile of MHOS in pediatric Japanese subjects was consistent with that observed in non-Japanese populations and may reduce the time to treatment and thereby minimize the sequelae of prolonged seizures.
A hospital-based study on caregiver preferences on acute seizure rescue medications in pediatric patients with epilepsy: Intranasal midazolam versus rectal diazepam
TLDR
These parents of children with epilepsy report increased ease of use, comfort, and efficacy with IN midazolam as compared with rectal diazepam suggesting that a readily available form of IN midAZolam would be well received in the pediatric population.
The evolution of the pilocarpine animal model of status epilepticus
TLDR
The various alterations made to the original pilocarpine model over the years to combat both the high mortality and low induction rates are highlighted.
Status Epilepticus-Work-Up and Management in Children.
TLDR
The diagnostic work-up should start simultaneously to initial treatment, or as soon as possible, to detect potentially treatable causes of SE, a life-threatening medical emergency in which prompt and efficacious treatment may improve outcomes.
Optimized Benzodiazepine Treatment of Pediatric Status Epilepticus Through a Standardized Emergency Medical Services Resuscitation Tool.
TLDR
EMS-focused training significantly increased the percentage of outpatient pediatric patients with SE who received recommended initial BZD treatment, and the need for further optimization of out-of-hospital SE care, particularly access to and timely use of second-line ASMs is suggested.
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References

SHOWING 1-10 OF 41 REFERENCES
Midazolam versus diazepam for the treatment of status epilepticus in children and young adults: a meta-analysis.
TLDR
Non-IV midazolam, compared to non-IV or IV diazepam, is safe and effective in treating SE, and comparison to lorazepam, evaluation in adults, and prospective confirmation of safety and efficacy is needed.
Lorazepam vs diazepam for pediatric status epilepticus: a randomized clinical trial.
TLDR
Among pediatric patients with convulsive status epilepticus, treatment with lorazepam did not result in improved efficacy or safety compared with diazepam, and these findings do not support the preferential use of lorzepam for this condition.
Continuous Midazolam Versus Diazepam Infusion for Refractory Convulsive Status Epilepticus
TLDR
Continuous midazolam and diazepam infusions were equally effective for control of refractory status epilepticus, however, midrazolam was associated with more seizure recurrence and higher mortality in refractors predominantly caused by central nervous system infections.
Comparing the Effect of Intravenous Midazolam with Rectal Sodium Valproate in Controlling of Children with Refractory Status Epilepticus
TLDR
The IV Midazolam was more effective than Sodium valproate, but the latter can be used in hospitals or pediatric emergency wards without ICU for controlling of refractory status epilepticus.
Comparison of intranasal midazolam with intravenous diazepam for treating acute seizures in children
TLDR
Although intranasal midazolam was as safe and effective as diazepam, seizures were controlled more quickly with intravenousdiazepam than with intran asal midrazolam.
Efficacy and safety of intramuscular midazolam versus rectal diazepam in controlling status epilepticus in children.
TLDR
IM midazolam is not superior but may be at least as effective as rectal diazepam for controlling of status epilepticus in children with convulsive status seizures who have difficult IV access.
A prospective, randomized study comparing intramuscular midazolam with intravenous diazepam for the treatment of seizures in children
TLDR
IM midazolam is an effective anticonvulsant for children with motor seizures compared to IV diazepam, and results in more rapid cessation of seizures because of more rapid administration.
Lorazepam versus diazepam-phenytoin combination in the treatment of convulsive status epilepticus in children: a randomized controlled trial.
TLDR
Lorazepam is recommended as a single drug to replace the two drug combination of diazepam-phenytoin combination to control the initial seizure in pediatric convulsive status epilepticus.
Safety and efficacy of buccal midazolam versus rectal diazepam for emergency treatment of seizures in children: a randomised controlled trial
TLDR
Buccal midazolam was more effective than rectal diazepam for children presenting to hospital with acute seizures and was not associated with an increased incidence of respiratory depression.
Comparison of intranasal midazolam with intravenous diazepam for treating febrile seizures in children: prospective randomised study
TLDR
The overall time to cessation of seizures after arrival at hospital was faster with intranasal midazolam than with intravenous diazepam, although midAZolam was as safe and effective as diazepAM.
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