A hospital-based study on caregiver preferences on acute seizure rescue medications in pediatric patients with epilepsy: Intranasal midazolam versus rectal diazepam

About 20 per 100,000 children have convulsive status epilepticus every year, a life-threatening condition. Benzodiazepines are the first-line treatment for prolonged and recurrent seizures. Our study was designed to gain understanding of caregiver perception of acute seizure treatments. Our project...

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Bibliographic Details
Published in:Epilepsy & behavior 2019-03, Vol.92, p.53-56
Main Authors: Nunley, Sunjay, Glynn, Peter, Rust, Steve, Vidaurre, Jorge, Albert, Dara V.F., Patel, Anup D.
Format: Article
Language:English
Subjects:
Administration, Intranasal
Administration, Rectal
Adolescent
Anticonvulsants
Benzodiazepines
Caregivers - trends
Child
Child, Preschool
Cross-Sectional Studies
Diazepam - administration & dosage
Female
Hospitalization - trends
Humans
Male
Midazolam - administration & dosage
Parents - psychology
Pediatric epilepsy
Rescue antiseizure medications
Status epilepticus
Status Epilepticus - diagnosis
Status Epilepticus - drug therapy
Surveys and Questionnaires
Young Adult
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Summary:About 20 per 100,000 children have convulsive status epilepticus every year, a life-threatening condition. Benzodiazepines are the first-line treatment for prolonged and recurrent seizures. Our study was designed to gain understanding of caregiver perception of acute seizure treatments. Our project uses a cross-sectional survey study design using the electronic medical record and a survey at a large academic tertiary children's medical center. Subjects were patients with epilepsy prescribed intranasal (IN) midazolam and/or per rectum (PR) diazepam. The survey was administered to caregivers of children with epilepsy regarding information on the comfort, efficacy, ease of use, and time of administration for patients receiving both abortive seizure medications. Exact binomial tests were employed to determine whether or not differences in caregiver preference exist. One hundred and sixty responses were obtained. Incomplete and duplicate surveys were excluded, leaving 153 responses. Of those responses, 59 respondents reported administering both medications. Among parents who expressed a preference for one medication over the other, more parents felt overall greater comfort with IN midazolam compared with rectal diazepam (p = 0.0004 and p = 0.001), IN midazolam was perceived as easier to use (68%, p = 0.0038 and 74%, p = 0.0004) and more effective (87%, p 
ISSN:1525-5050
1525-5069
DOI:10.1016/j.yebeh.2018.12.007