Abstract
BACKGROUND The rapidity with which a medication can be delivered to the systemic circulation and then into the brain always play a significant role in reducing the mortality and morbidity. We wanted to determine and compare the efficacy of intranasal midazolam with that of intravenous lorazepam in the control of acute onset seizures and side effects. METHODS This is an open labelled randomized control trial conducted in the Emergency Department of KIMS Hospital, which is a multi-specialty tertiary care centre in south Kerala, India, among children with acute seizure between 6 months and 15 years of age. They received intranasal midazolam or intravenous lorazepam. RESULTS 65.2 % (15) of the children in whom intranasal midazolam was given, seizures were controlled within 5 minutes from ER presentation, whereas in lorazepam group, only 34.8 % (8) children ceased to seizure within 5 minutes. P value was 0.039. CONCLUSIONS The overall time to cessation of seizure after arrival at hospital was faster with intranasal midazolam than intravenous lorazepam. No untoward side effects were noticed. KEYWORDS Acute Seizure in Children, Intranasal Midazolam, Lorazepam, Randomized Trial
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