Intravenous midazolam for the treatment of refractory status epilepticus

Crit Care Med. 1992 Apr;20(4):483-8. doi: 10.1097/00003246-199204000-00009.


Objective: To determine the usefulness of midazolam as a therapeutic agent for status epilepticus refractory to conventional treatment.

Design: Retrospective study.

Setting: ICUs of two university hospitals.

Patients: Seven patients with refractory status epilepticus who failed treatment with diazepam, lorazepam, and phenytoin, with or without phenobarbital. All patients received mechanical ventilation before receiving midazolam.

Interventions: Intravenous midazolam by bolus administration followed by infusion.

Measurements and main results: Midazolam terminated status epilepticus in all patients in less than 100 secs, as determined by clinical observation (three patients) or electroencephalographic monitoring (four patients). One patient developed mild hypotension.

Conclusions: In this small study, midazolam appears to be an effective and safe alternative to high-dose barbiturate coma for the termination of status epilepticus when conventional agents have failed.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anticonvulsants / therapeutic use
  • Child
  • Child, Preschool
  • Drug Resistance
  • Electroencephalography / drug effects
  • Female
  • Humans
  • Infant, Newborn
  • Infusions, Intravenous
  • Injections, Intravenous
  • Male
  • Midazolam / therapeutic use*
  • Retrospective Studies
  • Status Epilepticus / drug therapy*
  • Status Epilepticus / etiology
  • Status Epilepticus / physiopathology


  • Anticonvulsants
  • Midazolam