midazolam and Convulsions, Grand Mal studies

Midazolam: A short-acting hypnotic-sedative drug with anxiolytic and amnestic properties. It is used in dentistry, cardiac surgery, endoscopic procedures, as preanesthetic medication, and as an adjunct to local anesthesia. The short duration and cardiorespiratory stability makes it useful in poor-risk, elderly, and cardiac patients. It is water-soluble at pH less than 4 and lipid-soluble at physiological pH.
midazolam : An imidazobenzodiazepine that is 4H-imidazo[1,5-a][1,4]benzodiazepine which is substituted by a methyl, 2-fluorophenyl and chloro groups at positions 1, 6 and 8, respectively.

Research Excerpts

Excerpt	Relevance	Reference
" We aimed to find out whether there are differences in efficacy and adverse events between buccal administration of liquid midazolam and rectal administration of liquid diazepam in the acute treatment of seizures."	9.09	Buccal midazolam and rectal diazepam for treatment of prolonged seizures in childhood and adolescence: a randomised trial. ( Besag, FM; Neville, BG; Scott, RC, 1999)
"Acute strychnine poisoning is an uncommon form of intoxication, characterized by severe tonic clonic seizures and tetanus-like contractions while the patient is fully conscious."	7.81	[Strychnine poisoning: uncommon, but does still happen]. ( Arbouw, ME; Bles, CM; van Berlo-van de Laar, IR, 2015)
" We aimed to find out whether there are differences in efficacy and adverse events between buccal administration of liquid midazolam and rectal administration of liquid diazepam in the acute treatment of seizures."	5.09	Buccal midazolam and rectal diazepam for treatment of prolonged seizures in childhood and adolescence: a randomised trial. ( Besag, FM; Neville, BG; Scott, RC, 1999)
"Acute strychnine poisoning is an uncommon form of intoxication, characterized by severe tonic clonic seizures and tetanus-like contractions while the patient is fully conscious."	3.81	[Strychnine poisoning: uncommon, but does still happen]. ( Arbouw, ME; Bles, CM; van Berlo-van de Laar, IR, 2015)
" Magnesium sulfate (MGS) is used to suppress eclamptic seizures in pregnant women with hypertension and was shown to block kainate-induced convulsions."	3.79	Magnesium sulfate treatment against sarin poisoning: dissociation between overt convulsions and recorded cortical seizure activity. ( Bloch-Shilderman, E; Brandeis, R; Egoz, I; Grauer, E; Katalan, S; Lazar, S; Rabinovitz, I; Raveh, L, 2013)
"During her first pregnancy, a 37-year-old woman with idiopathic generalised epilepsy that was adequately controlled with lamotrigine experienced a series of epileptic seizures following an elective caesarean section."	3.73	[Epileptic seizures during childbirth in a patient with idiopathic generalised epilepsy]. ( Bloem, BR; Renier, WO; Voermans, NC; Zwarts, MJ, 2005)
"Depression is a common mental disorder."	2.50	Different regimens of intravenous sedatives or hypnotics for electroconvulsive therapy (ECT) in adult patients with depression. ( Ke, W; Lihua, P; Su, M; Ziemann-Gimmel, P, 2014)

Research

Studies (17)

Authors

Clinical Trials (2)

Trial Overview

Trial Outcomes

Length of Seizure After Study Medication Administration

Number of Patients Needed to be Seen or Treated in the Emergency Department for Their Seizure and Use of Study Medication.

Number of Patients That Were Admitted to the Hospital After Their Seizure and Use of Study Medication.

Number of Patients Who Had a Repeat Seizure Within 12 Hours After Their Seizure Who Used Study Medication

Number of Patients Who Needed Additional Medication to Treat the Seizure in the Emergency Department Within 24 Hours

Respiratory Depression Requiring Intubation

Timeframe	Studies, this research(%)	All Research%
pre-1990	0 (0.00)	18.7374
1990's	4 (23.53)	18.2507
2000's	7 (41.18)	29.6817
2010's	6 (35.29)	24.3611
2020's	0 (0.00)	2.80

Authors	Studies
McTague, A	1
Martland, T	1
Appleton, R	1
Belze, O	1
Remérand, F	1
Pujol, A	1
Fusciardi, J	1
Lihua, P	1
Su, M	1
Ke, W	1
Ziemann-Gimmel, P	1
van Berlo-van de Laar, IR	1
Arbouw, ME	1
Bles, CM	1
Breuer, L	1
Kasper, BS	1
Schwarze, B	1
Gschossmann, JM	1
Kornhuber, J	1
Müller, HH	1
Yano, T	1
Okubo, S	1
Naruo, H	1
Iwasaki, T	1
Takasaki, M	1
Tsuneyoshi, I	1
Prüss, H	1
Holtkamp, M	1
Katalan, S	1
Lazar, S	1
Brandeis, R	1
Rabinovitz, I	1
Egoz, I	1
Grauer, E	1
Bloch-Shilderman, E	1
Raveh, L	1
Voermans, NC	1
Zwarts, MJ	1
Renier, WO	1
Bloem, BR	1
Compton, R	1
Spiller, HA	1
Bosse, GM	1
Korkosz, A	1
Zatorski, P	1
Taracha, E	1
Plaznik, A	1
Kostowski, W	1
Bienkowski, P	1
Kerridge, IH	1
Nair, K	1
Whyte, I	1
Tonkin, A	1
Robb, ND	1
Briassoulis, G	1
Kalabalikis, P	1
Tamiolaki, M	1
Hatzis, T	1
Scott, RC	1
Besag, FM	1
Neville, BG	1
Fletcher, SJ	1
Parr, MJ	1
Segal, DC	1
Vofsi, O	1
Katz, Y	1

Trial	Phase	Enrollment	Study Type	Start Date	Status
A Pilot Study to Assess the Efficacy of Subanesthetic Doses of IV Ketamine in the Treatment Drug Resistant Epilepsy[NCT05019885]	Phase 2	6 participants (Anticipated)	Interventional	2022-08-26	Recruiting
Intranasal Midazolam Versus Rectal Diazepam for the Home Treatment of Seizure Activity in Pediatric Patients With Epilepsy[NCT00326612]	Phase 2	358 participants (Actual)	Interventional	2006-06-30	Completed
[information is prepared from clinicaltrials.gov, extracted Sep-2024]

Intervention	Minutes (Median)
Intranasal Midazolam	3.0
Rectal Diazepam	4.3

Intervention	participants (Number)
Intranasal Midazolam	21
Rectal Diazepam	17

Intervention	participants (Number)
Intranasal Midazolam	4
Rectal Diazepam	3

Intervention	participants (Number)
Intranasal Midazolam	1
Rectal Diazepam	1

Intervention	participants (Number)
Intranasal Midazolam	5
Rectal Diazepam	5

Respiratory depression was defined as intubation at Emergency Department discharge. (NCT00326612)
Timeframe: 24 hours

Respiratory Depression Requiring Oxygen at Discharge From the Emergency Department.

Intervention	participants (Number)
Intranasal Midazolam	1
Rectal Diazepam	0

Respiratory depression was defined as requiring oxygen at discharge from the Emergency Department. (NCT00326612)
Timeframe: 24 hours

Article	Year
Drug management for acute tonic-clonic convulsions including convulsive status epilepticus in children. The Cochrane database of systematic reviews, 2018, 01-10, Volume: 1 Topics: Administration, Inhalation; Administration, Oral; Administration, Rectal; Anticonvulsants; Child; Di	2018
Different regimens of intravenous sedatives or hypnotics for electroconvulsive therapy (ECT) in adult patients with depression. The Cochrane database of systematic reviews, 2014, Apr-11, Issue:4 Topics: Adult; Anesthetics, Intravenous; Depression; Electroconvulsive Therapy; Epilepsy, Tonic-Clonic; Etom	2014

Article	Year
Hyperammonaemic encephalopathy and a flat electroencephalogram caused by valproic acid. Acta anaesthesiologica Scandinavica, 2013, Volume: 57, Issue:8 Topics: Adult; Anesthesia, General; Anticonvulsants; Brain Diseases; Craniocerebral Trauma; Electroencephalo	2013
[Strychnine poisoning: uncommon, but does still happen]. Nederlands tijdschrift voor geneeskunde, 2015, Volume: 159 Topics: Acute Kidney Injury; Emergency Treatment; Epilepsy, Tonic-Clonic; Fever; Humans; Male; Midazolam; Mi	2015
"Herbal seizures"--atypical symptoms after ibogaine intoxication: a case report. Journal of medical case reports, 2015, Oct-31, Volume: 9 Topics: Adult; Anticonvulsants; Epilepsy, Tonic-Clonic; Hallucinogens; Humans; Hypnotics and Sedatives; Ibog	2015
Two cases with past and family history of febrile convulsion developed seizure-like movements during sevoflurane anesthesia. Anesthesiology, 2008, Volume: 109, Issue:3 Topics: Anesthesia, General; Anesthetics, Inhalation; Anesthetics, Intravenous; Appendectomy; Appendicitis;	2008
Ketamine successfully terminates malignant status epilepticus. Epilepsy research, 2008, Volume: 82, Issue:2-3 Topics: Anesthesia, General; Anesthetics, Dissociative; Anticonvulsants; Coma; DNA Polymerase gamma; DNA-Dir	2008
Magnesium sulfate treatment against sarin poisoning: dissociation between overt convulsions and recorded cortical seizure activity. Archives of toxicology, 2013, Volume: 87, Issue:2 Topics: Animals; Anticonvulsants; Antidotes; Brain Injuries; Cerebral Cortex; Chemical Warfare Agents; Cyclo	2013
[Epileptic seizures during childbirth in a patient with idiopathic generalised epilepsy]. Nederlands tijdschrift voor geneeskunde, 2005, Jun-18, Volume: 149, Issue:25 Topics: Adult; Anticonvulsants; Cesarean Section; Clonazepam; Diazepam; Epilepsy; Epilepsy, Generalized; Epi	2005
Fatal fluoxetine ingestion with postmortem blood concentrations. Clinical toxicology (Philadelphia, Pa.), 2005, Volume: 43, Issue:4 Topics: Adult; Anticonvulsants; Antidepressive Agents, Second-Generation; Bradycardia; Child, Preschool; Dia	2005
Ethanol blocks nicotine-induced seizures in mice: comparison with midazolam and baclofen. Alcohol (Fayetteville, N.Y.), 2006, Volume: 40, Issue:3 Topics: Animals; Anticonvulsants; Baclofen; Central Nervous System Depressants; Disease Models, Animal; Dose	2006
Seizures associated with the use of midazolam. Australian and New Zealand journal of medicine, 1995, Volume: 25, Issue:6 Topics: Aged; Cholangiopancreatography, Endoscopic Retrograde; Electroencephalography; Epilepsy, Tonic-Cloni	1995
Epileptic fits under intravenous midazolam sedation. British dental journal, 1996, Sep-07, Volume: 181, Issue:5 Topics: Adult; Anesthesia, Dental; Anesthetics, Intravenous; Anticonvulsants; Conscious Sedation; Epilepsy,	1996
Lamotrigine childhood overdose. Pediatric neurology, 1998, Volume: 19, Issue:3 Topics: Anticonvulsants; Child, Preschool; Drug Overdose; Epilepsy, Tonic-Clonic; Gastric Lavage; Humans; La	1998
Life-threatening magnesium toxicity. Intensive care medicine, 2000, Volume: 26, Issue:2 Topics: Adult; Anticonvulsants; Epilepsy, Tonic-Clonic; Female; Glasgow Coma Scale; Humans; Hypnotics and Se	2000
An alternative route of drug administration in acute convulsions. The Israel Medical Association journal : IMAJ, 2000, Volume: 2, Issue:8 Topics: Administration, Intranasal; Anti-Anxiety Agents; Child, Preschool; Epilepsy, Tonic-Clonic; Humans; M	2000

midazolam and Convulsions, Grand Mal