Page last updated: 2024-10-31

midazolam and Convulsive Generalized Seizure Disorder

midazolam has been researched along with Convulsive Generalized Seizure Disorder in 9 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

ExcerptRelevanceReference
" 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."9.09Buccal midazolam and rectal diazepam for treatment of prolonged seizures in childhood and adolescence: a randomised trial. ( Besag, FM; Neville, BG; Scott, RC, 1999)
" 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."5.09Buccal midazolam and rectal diazepam for treatment of prolonged seizures in childhood and adolescence: a randomised trial. ( Besag, FM; Neville, BG; Scott, RC, 1999)
"We present a patient with peritoneal carcinosarcoma who was treated with the alkylating agent ifosfamide and experienced a rapid decline in mental status."4.90Ifosfamide chemotherapy and nonconvulsive status epilepticus: case report and review of the literature. ( Friedman, D; Racela, R; Taupin, D, 2014)
"The aim of this study was to review out-of-hospital use of intranasal diazepam and midazolam for treatment of acute repetitive seizures (ARS) at a typical adult epilepsy center."4.12Use of new intranasal benzodiazepines at a typical adult epilepsy center. ( Benbadis, SR; Li, C, 2022)
"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)
"A second dose could be given if seizures did not terminate within 10 min or recurred from 10 min to 6 h."3.30Psychosocial outcomes of repeated treatment of seizure clusters with midazolam nasal spray: Results of a phase 3, open-label extension trial. ( Brunnert, M; Campos, R; Chen, L; Fakhoury, T; Meng, TC; Pullman, WE; Szaflarski, JP; Van Ess, P, 2023)
"The primary goal of treatment for seizure clusters is cessation of the cluster to avoid progression to more severe conditions, such as prolonged seizures and status epilepticus."2.82Rescue therapies for seizure clusters: Pharmacology and target of treatments. ( Detyniecki, K; Gidal, B, 2022)
"A fatal case of gas embolism during diagnostic hysteroscopy using carbon dioxide (CO2) is presented."1.30Gas embolism during hysteroscopy. ( Hanaoka, K; Nishiyama, T, 1999)

Research

Studies (9)

TimeframeStudies, this research(%)All Research%
pre-19900 (0.00)18.7374
1990's3 (33.33)18.2507
2000's1 (11.11)29.6817
2010's1 (11.11)24.3611
2020's4 (44.44)2.80

Authors

AuthorsStudies
Li, C1
Benbadis, SR1
Gidal, B1
Detyniecki, K1
Meng, TC3
Szaflarski, JP3
Chen, L3
Brunnert, M3
Campos, R3
Van Ess, P3
Pullman, WE3
Fakhoury, T3
Wu, K1
Hirsch, LJ1
Babl, FE1
Josephson, SA1
Taupin, D1
Racela, R1
Friedman, D1
Voermans, NC1
Zwarts, MJ1
Renier, WO1
Bloem, BR1
Cascino, GD1
Scott, RC1
Besag, FM1
Neville, BG1
Nishiyama, T1
Hanaoka, K1

Clinical Trials (2)

Trial Overview

TrialPhaseEnrollmentStudy TypeStart DateStatus
An Open-Label Safety Study of USL261 in the Outpatient Treatment of Subjects With Seizure Clusters[NCT01529034]Phase 3175 participants (Actual)Interventional2012-07-31Terminated
Intranasal Midazolam Versus Rectal Diazepam for the Home Treatment of Seizure Activity in Pediatric Patients With Epilepsy[NCT00326612]Phase 2358 participants (Actual)Interventional2006-06-30Completed
[information is prepared from clinicaltrials.gov, extracted Sep-2024]

Trial Outcomes

Duration of Safety Observation

Duration of participant study participation for collection of long term safety data (NCT01529034)
Timeframe: From Baseline/(Screening) to End of Safety-Follow-up (up to 56 months) as per assessment table of the study.

Interventionmonths (Median)
USL26116.80

Emergency Room/Emergency Medical Service Visits

Participants requiring emergency room (ER)/emergency medical service (EMS) visit within 24 hours after any USL261 treated seizure cluster (including for continued seizures) (NCT01529034)
Timeframe: From Baseline/(Screening) to End of Safety-Follow-up (up to 56 months) as per assessment table of the study.

InterventionParticipants (Count of Participants)
USL26120

Number of Treated Seizure Clusters Meeting Criteria for Treatment Success

Number of Treated Seizure Clusters Meeting Criteria for Treatment Success: Termination of seizure(s) within 10 minutes and no recurrence within 6 hours after administration of first dose of USL261 (intranasal midazolam 5 mg) (NCT01529034)
Timeframe: 6 hours after first dose of USL261 for each treated seizure cluster

InterventionSeizure cluster episodes (Count of Units)
USL2611108

Participant Change in B-SIT Score

Change in participant Brief Smell Identification Test (B-SIT) score from baseline to last visit with assessment. The B-SIT is a self-administered 12-item test; the score indicates odors correctly identified (0 to 12). The B-SIT was added while the study was already ongoing (Protocol Amendment 4, 20 May 2015) in response to a regulatory request. The test was only implemented at sites in the United States and included only participants considered by the investigator to have adequate cognitive ability to perform the test. Baseline was defined as the latest non-missing value prior to administration of USL261 in the Test Dose Phase of Study P261-401. (NCT01529034)
Timeframe: From Baseline/(Screening) to End of Safety-Follow-up (up to 56 months) as per assessment table of the study.

Interventionscore on a scale (Mean)
USL261-0.6

Participants With Clinically Significant Abnormalities on Nasal Examination

Participants with abnormal findings, at any time post baseline, on nasal examination considered clinically significant by the investigator (NCT01529034)
Timeframe: From Baseline/(Screening) to End of Safety-Follow-up (up to 56 months) as per assessment table of the study.

InterventionParticipants (Count of Participants)
USL2611

Participants Meeting Predefined Safety Criteria for Vital Signs

Participants meeting predefined safety criteria for vital signs (systolic blood pressure [SBP] <85 mm Hg, SBP change from baseline >/= 40 mm Hg, diastolic BP [DBP] <50 mm Hg, DBP change from baseline >/=30 mm Hg, pulse rate <50 beats per minute (bpm), pulse rate >120 bpm, pulse rate change >/= 40 bpm at any visit post baseline or for caregiver recorded participant respiration rate [RR] <8 breaths per minute (brpm) or >24 brpm) after any USL261 treated seizure cluster episode. Abnormal vital signs were assessed separately by investigator and recorded as adverse events if applicable. (NCT01529034)
Timeframe: From Baseline/(Screening) to End of Safety-Follow-up (up to 56 months) as per assessment table of the study.

InterventionParticipants (Count of Participants)
SBP <85 mm HgSBP change from baseline ≥ 40 mm HgDBP <50 mm HgDBP change from baseline ≥ 30 mm HgPulse rate <50 bpmPulse rate >120 bpmPulse rate change from baseline >/= 40 bpmCaregiver recorded RR <8 brpmCaregiver recorded RR >24 brpm
USL2610123214129

Participants With Clinically Significant Abnormalities on Neurologic Examination

Participants with abnormal findings, at any time post baseline, on neurologic examination considered clinically significant by the investigator (NCT01529034)
Timeframe: From Baseline/(Screening) to End of Safety-Follow-up (up to 56 months) as per assessment table of the study.

InterventionParticipants (Count of Participants)
Mental statusCranial nerves II-XIIMotor strength of limbsDeep tendon reflexesSensory examStation and gaitHoppingRomberg testFinger-to-nose testHeel-to-shin testRapid alternating movementsNystagmusTremor/Other abnormal movements
USL26110122150011200

Participants With Clinically Significant Abnormalities Physical Examination

Participants with abnormal findings, at any time post baseline, on physical examination considered clinically significant by the investigator. (NCT01529034)
Timeframe: From Baseline/(Screening) to End of Safety-Follow-up (up to 56 months) as per assessment table of the study.

InterventionParticipants (Count of Participants)
SkinHead/Eyes/Ears/Nose/ThroatNeckThyroidLungsHeartAbdomenLymph nodesExtremities
USL261201000000

Participants With Laboratory Abnormalities Meeting Predefined Criteria

Participants with abnormal laboratory finding, at any time post baseline, meeting predefined criteria. Abnormal laboratory findings were assessed separately by investigator and recorded as adverse events if applicable. Alanine aminotransferase (ALT); Alkaline phosphatase (ALP); Aspartate aminotransferase (AST); Gamma glutamyl transferase (GGT); upper limit of normal (ULN) (NCT01529034)
Timeframe: From Baseline/(Screening) to End of Safety-Follow-up (up to 56 months) as per assessment table of the study.

InterventionParticipants (Count of Participants)
ALT >ULN & ≤3xULNAlbumin <30 g/LALP >2.5xULNAST >ULN & ≤3xULNAST >5x ULN & <20xULNBicarbonate <15.9 mmol/LCholesterol >7.75 mmol/LCreatinine >1.5xULNCreatinine >2x baselineGGT >2.5xULNGlucose <3 mmol/LGlucose <8.9 mmol/LPhosphate <0.8 mmol/LPotassium >5.5 mmol/LSodium <130 mmol/LSodium >150 mmol/LHemoglobin <100 g/LHemoglobin decrease 20 g/LLeukocytes <3x10^9/LLymphocytes <0.8x10^9/LNeutrophils <1.5x10^9/L
USL261262117165121435135111510448

Participants With Suicidal Ideation

Participants with suicidal ideation reported on Columbia-Suicide Severity Rating Scale (C-SSRS) questionnaire at any post-baseline visit. Responses including: Wish to be Dead; Non-Specific Active Suicidal Thoughts; Active Suicidal Ideation with Some Intent to Act, without Specific Plan; Active Suicidal Ideation with Specific Plan and Intent; and Any Suicidal Ideation Regardless of Type. (NCT01529034)
Timeframe: From Baseline/(Screening) to End of Safety-Follow-up (up to 56 months) as per assessment table of the study.

InterventionParticipants (Count of Participants)
Wish to be deadNon-specific activeActive without specific planActive with specific plan/intentAny suicidal ideation
USL26133314

Length of Seizure After Study Medication Administration

Length of seizure. (NCT00326612)
Timeframe: 24 hours

InterventionMinutes (Median)
Intranasal Midazolam3.0
Rectal Diazepam4.3

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

(NCT00326612)
Timeframe: 24 hours

Interventionparticipants (Number)
Intranasal Midazolam21
Rectal Diazepam17

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

(NCT00326612)
Timeframe: 24 hours

Interventionparticipants (Number)
Intranasal Midazolam4
Rectal Diazepam3

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

(NCT00326612)
Timeframe: 12 hours

Interventionparticipants (Number)
Intranasal Midazolam1
Rectal Diazepam1

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

(NCT00326612)
Timeframe: 24 hours

Interventionparticipants (Number)
Intranasal Midazolam5
Rectal Diazepam5

Respiratory Depression Requiring Intubation

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

Interventionparticipants (Number)
Intranasal Midazolam1
Rectal Diazepam0

Respiratory Depression Requiring Oxygen at Discharge From the Emergency Department.

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

Interventionparticipants (Number)
Intranasal Midazolam3
Rectal Diazepam1

Reviews

2 reviews available for midazolam and Convulsive Generalized Seizure Disorder

ArticleYear
Rescue therapies for seizure clusters: Pharmacology and target of treatments.
    Epilepsia, 2022, Volume: 63 Suppl 1

    Topics: Administration, Intranasal; Adolescent; Adult; Anticonvulsants; Benzodiazepines; Diazepam; Epilepsy,

2022
Ifosfamide chemotherapy and nonconvulsive status epilepticus: case report and review of the literature.
    Clinical EEG and neuroscience, 2014, Volume: 45, Issue:3

    Topics: Carcinosarcoma; Cerebral Cortex; Diagnosis, Differential; Electroencephalography; Epilepsy, Generali

2014

Trials

2 trials available for midazolam and Convulsive Generalized Seizure Disorder

ArticleYear
Psychosocial outcomes of repeated treatment of seizure clusters with midazolam nasal spray: Results of a phase 3, open-label extension trial.
    Epilepsy & behavior : E&B, 2023, Volume: 138

    Topics: Epilepsy, Generalized; Humans; Midazolam; Nasal Sprays; Quality of Life; Seizures; Treatment Outcome

2023
Psychosocial outcomes of repeated treatment of seizure clusters with midazolam nasal spray: Results of a phase 3, open-label extension trial.
    Epilepsy & behavior : E&B, 2023, Volume: 138

    Topics: Epilepsy, Generalized; Humans; Midazolam; Nasal Sprays; Quality of Life; Seizures; Treatment Outcome

2023
Psychosocial outcomes of repeated treatment of seizure clusters with midazolam nasal spray: Results of a phase 3, open-label extension trial.
    Epilepsy & behavior : E&B, 2023, Volume: 138

    Topics: Epilepsy, Generalized; Humans; Midazolam; Nasal Sprays; Quality of Life; Seizures; Treatment Outcome

2023
Psychosocial outcomes of repeated treatment of seizure clusters with midazolam nasal spray: Results of a phase 3, open-label extension trial.
    Epilepsy & behavior : E&B, 2023, Volume: 138

    Topics: Epilepsy, Generalized; Humans; Midazolam; Nasal Sprays; Quality of Life; Seizures; Treatment Outcome

2023
Psychosocial outcomes of repeated treatment of seizure clusters with midazolam nasal spray: Results of a phase 3, open-label extension trial.
    Epilepsy & behavior : E&B, 2023, Volume: 138

    Topics: Epilepsy, Generalized; Humans; Midazolam; Nasal Sprays; Quality of Life; Seizures; Treatment Outcome

2023
Psychosocial outcomes of repeated treatment of seizure clusters with midazolam nasal spray: Results of a phase 3, open-label extension trial.
    Epilepsy & behavior : E&B, 2023, Volume: 138

    Topics: Epilepsy, Generalized; Humans; Midazolam; Nasal Sprays; Quality of Life; Seizures; Treatment Outcome

2023
Psychosocial outcomes of repeated treatment of seizure clusters with midazolam nasal spray: Results of a phase 3, open-label extension trial.
    Epilepsy & behavior : E&B, 2023, Volume: 138

    Topics: Epilepsy, Generalized; Humans; Midazolam; Nasal Sprays; Quality of Life; Seizures; Treatment Outcome

2023
Psychosocial outcomes of repeated treatment of seizure clusters with midazolam nasal spray: Results of a phase 3, open-label extension trial.
    Epilepsy & behavior : E&B, 2023, Volume: 138

    Topics: Epilepsy, Generalized; Humans; Midazolam; Nasal Sprays; Quality of Life; Seizures; Treatment Outcome

2023
Psychosocial outcomes of repeated treatment of seizure clusters with midazolam nasal spray: Results of a phase 3, open-label extension trial.
    Epilepsy & behavior : E&B, 2023, Volume: 138

    Topics: Epilepsy, Generalized; Humans; Midazolam; Nasal Sprays; Quality of Life; Seizures; Treatment Outcome

2023
Buccal midazolam and rectal diazepam for treatment of prolonged seizures in childhood and adolescence: a randomised trial.
    Lancet (London, England), 1999, Feb-20, Volume: 353, Issue:9153

    Topics: Administration, Buccal; Administration, Rectal; Adolescent; Adult; Anti-Anxiety Agents; Anticonvulsa

1999

Other Studies

5 other studies available for midazolam and Convulsive Generalized Seizure Disorder

ArticleYear
Use of new intranasal benzodiazepines at a typical adult epilepsy center.
    Epilepsy & behavior : E&B, 2022, Volume: 134

    Topics: Administration, Intranasal; Adult; Anticonvulsants; Benzodiazepines; Diazepam; Epilepsy; Epilepsy, G

2022
Choosing Anticonvulsant Medications to Manage Status Epilepticus.
    The New England journal of medicine, 2020, 06-25, Volume: 382, Issue:26

    Topics: Adult; Anticonvulsants; Disease Management; Drug Therapy, Combination; Epilepsy, Generalized; Female

2020
[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
Generalized convulsive status epilepticus.
    Mayo Clinic proceedings, 1996, Volume: 71, Issue:8

    Topics: Adolescent; Adult; Aged; Anesthetics; Anticonvulsants; Benzodiazepines; Child; Epilepsy, Generalized

1996
Gas embolism during hysteroscopy.
    Canadian journal of anaesthesia = Journal canadien d'anesthesie, 1999, Volume: 46, Issue:4

    Topics: Aged; Anticoagulants; Carbon Dioxide; Cardiopulmonary Resuscitation; Catheterization, Central Venous

1999