A Comparison of Buccal Midazolam and Intravenous Diazepam for the Acute Treatment of Seizures in Children

Objective: the purpose of the present study is to compare efficacy and safety of buccal midazolam with intravenous diazepam in control of seizures in iranian children. methods: this is a randomized clinical trial. 92 patients with acute seizures, ranging from 6 months to 14 years were randomly assigned to receive either buccal midazolam (32 cases) or intravenous diazepam (60 cases) at the emergency department of a children's hospital. the primary outcome of this study was cessation of visible seizure activity within 5 minutes from administration of the first dosage. the second dosage was used in case the seizure remained uncontrolled 5 minutes after the first one. findings: in the midazolam group, 22 (68.8%) patients were relieved from seizures in 10 minutes. meanwhile, diazepam controlled the episodes of 42 (70%) patients within 10 minutes. the difference was, however, not statistically significant (p=0.9). the mean time required to control the convulsive episodes after administration of medications was not statistically significant (p=0.09). no significant side effects were observed in either group. nevertheless, the risk of respiratory failure in intravenous diazepam is greater than in buccal midazolam. conclusion: buccal midazolam is as effective as and safer than intravenous diazepam in control of seizures.