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Abstract Ref Number = APCP1125
Poster Presentation
Impact of intranasal Midazolam as rescue medication for domiciliary management of acute seizure among children with epilepsy
Tanvi Lather ,Jai Behgal,Jaya Shankar Kaushik
Pandit BD Sharma PGIMS Rohtak Pt BD Sharma, PGIMS, Rohtak
Background : Intranasal midazolam is commonly prescribed as rescue medication for domiciliary management of seizure. The present study aimed to determine its efficacy and its impact on number of hospital visits and health care utilization in Indian children with epilepsy.
Material : A descriptive cross sectional study was conducted among children with epilepsy aged 1-14 years who have used intranasal midazolam to abort seizure at home. Children with epilepsy who have not used intranasal midazolam served as controls. Efficacy was assessed in terms of correctness of its use, time taken to abort seizure, and need for emergency hospital visit.
Results : The baseline demographic and seizure characteristics were comparable between the cases and controls. The median (IQR) number of times the drug has been used was 2.0 (1.0,3.0). The time taken to administer the drug and to abort the seizure was 1 (1, 2) minute and 2.5 (1.0, 5.2) minutes respectively. Seizures were aborted only in 36 (72%) cases and 4(8%) cases required second dose. Cases had significantly higher proportion of correct method of administration when compared to controls [43(86%) vs. 17(34%); p<0.01). Number of emergency department (ED) visits was significantly more in cases when compared to controls [2.9 vs. 1.4; p<0.01]. Cases reached at ED with seizure [18(36%) vs. 9(18%); p=0.02]. Requirement of oxygen supplementation and in patient admission was significantly higher among cases.
Conclusions : Seizure was not aborted in one fourth of children who were prescribed intranasal midazolam which required hospital emergency visit and increased utilization of health care resources despite good knowledge of the correct method. This study with limited sample size, prompts us to introspect the practice of intranasal midazolam for children with epilepsy
Keywords: Seizures Epilepsy Midazolam Hydrochloride Child
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