Midazolam in neonatal seizures with no response to phenobarbital

Neurology. 2005 Mar 8;64(5):876-9. doi: 10.1212/01.WNL.0000152891.58694.71.

Abstract

The outcome of 45 neonates with EEG-confirmed seizures (ESz) was analyzed with regard to treatment. ESz persisted in 17 of 32 neonates receiving phenobarbital/phenytoin (13 had a poor outcome, 4 died). In contrast, ESz were rapidly controlled in 13 of 13 nonresponders to phenobarbital/phenytoin treated with midazolam (4 had poor outcome, 2 died). Nonresponders to phenobarbital/phenytoin had a significantly worse outcome than responders did. Midazolam effectively controlled ESz in nonresponders to phenobarbital/phenytoin and correlated with significantly improved long-term neurodevelopment.

Publication types

  • Clinical Trial

MeSH terms

  • Age Factors
  • Anticonvulsants / administration & dosage
  • Anticonvulsants / adverse effects
  • Anticonvulsants / therapeutic use
  • Brain / drug effects
  • Brain / growth & development
  • Brain / physiopathology
  • Dose-Response Relationship, Drug
  • Drug Resistance / physiology
  • Electroencephalography
  • Epilepsy, Benign Neonatal / diagnosis
  • Epilepsy, Benign Neonatal / drug therapy*
  • Epilepsy, Benign Neonatal / physiopathology
  • GABA Modulators / administration & dosage
  • GABA Modulators / adverse effects
  • GABA Modulators / therapeutic use
  • Humans
  • Infant, Newborn
  • Midazolam / administration & dosage*
  • Midazolam / adverse effects
  • Midazolam / therapeutic use
  • Phenobarbital / administration & dosage*
  • Phenobarbital / adverse effects
  • Phenobarbital / therapeutic use
  • Retrospective Studies
  • Seizures / diagnosis
  • Seizures / drug therapy*
  • Seizures / physiopathology
  • Treatment Outcome

Substances

  • Anticonvulsants
  • GABA Modulators
  • Midazolam
  • Phenobarbital