Study examines effectiveness of medications for treating epileptic seizures in children

April 22, 2014

Although some studies have suggested that the drug lorazepam may be more effective or safer than the drug diazepam in treating a type of epileptic seizures among children, a randomized trial finds that lorazepam is not better at stopping seizures compared to diazepam, according to a study in the April 23/30 issue of JAMA, a neurology theme issue.

Status epilepticus is a prolonged epileptic seizure or seizures that occurs approximately 10,000 times in children annually in the United States. Rapid control of status epilepticus is essential to avoid permanent injury and life-threatening complications such as respiratory failure. The Food and Drug Administration has approved , but not lorazepam, for the treatment of status epilepticus in children. Studies involving lorazepam have shown mixed results, according to background information in the article.

James M. Chamberlain, M.D., of the Children's National Medical Center, Washington, D.C., and colleagues with the Pediatric Emergency Care Applied Research Network, randomly assigned 273 patients (age 3 months to younger than 18 years with convulsive status epilepticus) presenting to one of 11 pediatric emergency departments to receive diazepam or lorazepam intravenously.

The researchers found that the primary measure of effectiveness, cessation of status epilepticus for 10 minutes without recurrence within 30 minutes, occurred in 101 of 140 (72.1 percent) in the diazepam group and 97 of 133 (72.9 percent) in the lorazepam group. Twenty-six patients in each group required assisted ventilation (the primary safety outcome; 16.0 percent given diazepam and 17.6 percent given lorazepam).

There were no significant differences in other outcomes such as rates of seizure recurrence and time to cessation of convulsions, except that patients receiving lorazepam were more likely to experience sedation (67 percent vs 50 percent).

The authors write that the study results have important implications for both outside the hospital and emergency department care. "Diazepam can be stored without refrigeration and thus has been used as the treatment of choice in many prehospital systems. The results of this study do not support the superiority of over diazepam as a first-line agent for pediatric status epilepticus."

The researchers add that future trials should consider newer medications and novel interventions targeting those at highest risk for medication failure or respiratory depression.

Explore further: Early treatment with AED reduces duration of febrile seizures

More information: DOI: 10.1001/jama.2014.2625

Related Stories

Early treatment with AED reduces duration of febrile seizures

February 6, 2014
New research shows that children with febrile status epilepticus (FSE) who receive earlier treatment with antiepileptic drugs (AEDs) experience a reduction in the duration of the seizure. The study published in Epilepsia, ...

Improved emergency treatment for prolonged seizures: National trial shows autoinjectors fast, effective

February 15, 2012
When a person is experiencing a prolonged convulsive seizure, quick medical intervention is critical. With every passing minute, the seizure becomes harder to stop, and can place the patient at risk of brain damage and death. ...

Potential treatment prevents damage from prolonged seizures

February 11, 2013
A new type of prophylactic treatment for brain injury following prolonged epileptic seizures has been developed by Emory University School of Medicine investigators.

Study supports use of quick shot for seizures

February 27, 2012
For treating prolonged seizures outside a hospital setting, a quick intramuscular shot of anti-convulsant medication with an auto-injector, a kind of spring-loaded syringe, is as effective — if not more effective — ...

Promising new finding for therapies to treat persistent seizures in epileptic patients

January 16, 2013
In a promising finding for epileptic patients suffering from persistent seizures known as status epilepticus, researchers reported today that new medication could help halt these devastating seizures. To do so, it would have ...

Recommended for you

'Residual echo' of ancient humans in scans may hold clues to mental disorders

July 26, 2017
Researchers at the National Institute of Mental Health (NIMH) have produced the first direct evidence that parts of our brains implicated in mental disorders may be shaped by a "residual echo" from our ancient past. The more ...

Cellular roots of anxiety identified

July 26, 2017
From students stressing over exams to workers facing possible layoffs, worrying about the future is a normal and universal experience. But when people's anticipation of bad things to come starts interfering with daily life, ...

Laser used to reawaken lost memories in mice with Alzheimer's disease

July 26, 2017
(Medical Xpress)—A team of researchers at Columbia University has found that applying a laser to the part of a mouse brain used for memory storage caused the mice to recall memories lost due to a mouse version of Alzheimer's ...

Brain disease seen in most football players in large report

July 25, 2017
Research on 202 former football players found evidence of a brain disease linked to repeated head blows in nearly all of them, from athletes in the National Football League, college and even high school.

Zebrafish study reveals clues to healing spinal cord injuries

July 25, 2017
Fresh insights into how zebrafish repair their nerve connections could hold clues to new therapies for people with spinal cord injuries.

Lutein may counter cognitive aging, study finds

July 25, 2017
Spinach and kale are favorites of those looking to stay physically fit, but they also could keep consumers cognitively fit, according to a new study from University of Illinois researchers.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.