ArticleNeurology2015
Efficacy of nonvenous medications for acute convulsive seizures: A network meta-analysis.
Article in Neurology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 67 citations in OpenAlex.
- Prehospital rescue treatment of cluster epileptic seizures and status epilepticus.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Review
- [Leading symptom: motor manifestations with impaired consciousnes : Management of epileptic seizures and status epilepticus].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025Review
- Relative Bioavailability Study of Midazolam Intramuscularly Administered with the Needle-Free Auto-Injector ZENEONeurology and therapy · 2024Article
- Out-of-hospital rescue medication in dogs with emergency seizure disorders: an owner perspective.Frontiers in veterinary science · 2023Article
- [S2k guidelines: status epilepticus in adulthood : Guidelines of the German Society for Neurology].Der Nervenarzt · 2021Review
- First-line management of canine status epilepticus at home and in hospital-opportunities and limitations of the various administration routes of benzodiazepines.BMC veterinary research · 2021Review
- Refractory and Super-refractory Status Epilepticus.Indian pediatrics · 2020Review
- Pharmacotherapy for Pediatric Convulsive Status Epilepticus.CNS drugs · 2020Review
- Intranasal midazolam as first-line inhospital treatment for status epilepticus: a pharmaco-EEG cohort study.Annals of clinical and translational neurology · 2019Article
- [Acute focal neurological deficits in the emergency room].Der Nervenarzt · 2017Review
- Polytherapy as first-line in status epilepticus: should we change our practice? "Time is brain"!Annals of translational medicine · 2016Article
- Treatment of Convulsive Status Epilepticus.Current treatment options in neurology · 2016Article
- Identifying Barriers to Care in the Pediatric Acute Seizure Care Pathway.International journal of integrated careArticle
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- Intravenous Clonazepam in Status Epilepticus.Epilepsy currentsArticle
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveThis is a network meta-analysis of nonvenous drugs used in randomized controlled trials (RCTs) for treatment of acute convulsive seizures and convulsive status epilepticus.
methodsLiterature was searched according to Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines for RCTs examining treatment of acute convulsive seizures or status epilepticus with at least one of the study arms being a nonvenous medication. After demographic and outcome data extraction, a Bayesian network meta-analysis was performed and efficacy results were summarized using treatment effects and their credible intervals (CrI). We also calculated the probability of each route-drug combination being the most clinically effective for a given outcome, and provided their Bayesian hierarchical ranking.
resultsThis meta-analysis of 16 studies found that intramuscular midazolam (IM-MDZ) is superior to other nonvenous medications regarding time to seizure termination after administration (2.145 minutes, 95% CrI 1.308-3.489), time to seizure cessation after arrival in the hospital (3.841 minutes, 95% CrI 2.697-5.416), and time to initiate treatment (0.779 minutes, 95% CrI 0.495-1.221). Additionally, intranasal midazolam (IN-MDZ) was adjudged most efficacious for seizure cessation within 10 minutes of administration (90.4% of participants, 95% CrI 79.4%-96.9%), and persistent seizure cessation for ≥1 hour (78.5% of participants, 95% CrI 59.5%-92.1%). Paucity of RCTs produced evidence gaps resulting in small networks, routes/drugs included in some networks but not others, and some trials not being connected to any network.
conclusionsDespite the evidence gaps, IM-MDZ and IN-MDZ exhibit the best efficacy data for the nonvenous treatment of acute convulsive seizures or status epilepticus.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.