New Epilepsy Treatment Better at Halting Prolonged Seizures

By Adam Modzelesky
EpilepsyUSA staff
Posted: November 16, 2005

In a recent study that was published in the July 16 issue of the medical journal The Lancet, researchers report a new treatment that could be more effective at treating prolonged seizures, as well as saving a trip to the emergency room for adults and offering a more dignified therapy for children.

For decades, tranquilizers, such as Valium, have been administered to adults intravenously at the hospital to stop prolonged seizures. Children, on the other hand, have had to endure treatments administered in the rectum. All of that could now change with the discovery of buccal midazolam, which involves infusing a tranquilizer into the mouth between the gums and cheek. This treatment can only be administered in a hospital emergency room.

"This study involved exceptional seizures, but I think the medication will be much more widely used," said Gregory L. Barkley, M.D., chair of the Epilepsy Foundation's professional advisory board. "If it is cheap and easy to administer, I would think most people with epilepsy would like to have medication like this available for emergencies – a little extra insurance."

The study, headed up by John McIntyre, M.D., M.R.C.P., M.R.C.P.C.H., of the University of Nottingham in England, involved 219 convulsions in 177 children brought to the emergency room while experiencing prolonged seizures. Not all of the children were having epileptic seizures; some were having seizures related to fever. The doctors treated 110 patients with rectally-administered diazepam or Valium, and 109 patients with mouth-administered midazolam. They later evaluated how successful each therapy was at stopping the seizure within 10 minutes and maintaining the seizure-free state for at least an hour. The midazolam worked twice as well and kicked in more quickly, demonstrating success 61 times (57 percent). The rectal infusion worked only 30 times (27 percent).

"This is a finding that's likely to be used extensively," Barkley said. "I anticipate we will employ this extensively."