ArticleCNS drugs2018
Use of Emergency Medication in Adult Patients with Epilepsy: A Multicentre Cohort Study from Germany.
Article in CNS drugs, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 36 citations in OpenAlex.
- Efficacy and Tolerability of Intranasal Midazolam Administration for Antiseizure Treatment in Adults: A Systematic Review.Neurocritical care · 2024Pooled it
- Breaking the seizure cycle: Belgian expert consensus on the diagnostics and treatment of acute convulsive seizures in children.Acta neurologica Belgica · 2026Review
- Midazolam Oromucosal Solution for the Management of Prolonged Convulsive Seizures in Adult Outpatients: Addressing Unmet Needs in Europe.Clinical drug investigation · 2025Review
- Opportunities for and Challenges of Pulmonary Drug Delivery in the Management of Acute Exacerbations of CNS Disorders.CNS drugs · 2025Review
- Medications used for seizure-emergency management in the UK community: A clinical practice research datalink retrospective database study.Epilepsia open · 2025Article
- Relative Bioavailability Study of Midazolam Intramuscularly Administered with the Needle-Free Auto-Injector ZENEONeurology and therapy · 2024Article
- How Intuitive Is the Administration of Pediatric Emergency Medication Devices for Parents? Objective Observation and Subjective Self-Assessment.Pharmacy (Basel, Switzerland) · 2024Article
- Benzodiazepines for the Treatment of Seizure Clusters.CNS drugs · 2024Review
- Article
- Treatment of pediatric convulsive status epilepticus.Frontiers in neurology · 2023Review
- Epidemiology, real-world treatment and mortality of patients with status epilepticus in Germany: insights from a large healthcare database.Brain communications · 2023Article
- Review
- Observational
- Intranasal midazolam as first-line inhospital treatment for status epilepticus: a pharmaco-EEG cohort study.Annals of clinical and translational neurology · 2019Article
- Emergency First-Line Anti-Seizure Medication for Seizures and Status Epilepticus: What is Going Wrong, Doctor?CNS drugs · 2018Article
Corrections and comments
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Authors and funding
11 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEmergency treatment with benzodiazepines is indicated in prolonged seizures, seizure clusters and status epilepticus.
objectiveThe aim of this study was to evaluate the use of emergency medication in adult patients with epilepsy. PATIENTS AND
methodsAll adult epilepsy patients attending the epilepsy outpatient clinics of the university hospitals in Frankfurt and Marburg in 2015 were asked to participate in this questionnaire-based, retrospective survey.
resultsA total of 481 patients with a mean age of 43.4 years (range 18-94 years, 54% female) participated in the study. Among them, 134 patients (27.9%) reported on the prescription of an emergency medication during the last year. Patients receiving emergency medication were younger and exhibited a lower age at epilepsy onset, a higher seizure frequency and a higher number of regularly taken antiepileptic drugs. The most frequently taken emergency drugs were oral lorazepam tablets (65.7%; n = 88 out of 134), followed by buccal midazolam (23.9%, n = 32) and rectal diazepam (17.9%, n = 24). The most common indications for administering the emergency medication were seizures continuing for several minutes (35.1%, n = 47), but almost the same number of patients (33.6%, n = 45) stated that the rescue medication was given during or after every seizure. Regarding adverse events, sedation was named as a major (18.7%, n = 25) or moderate (29.1%; n = 39) problem by a substantial number of patients. Difficulties in administration were reported by 17 (13%) patients. Two-thirds assessed the efficacy of their emergency medication as good (50.7%, n = 68) or as very good (15.7%, n = 21). For multivariate logistic regression analysis, aspects such as young age at onset, active epilepsy, structural etiology, presence of generalised tonic-clonic seizures, past medical history of status epilepticus and living with another person independently predicted prescription of emergency medication.
conclusionsIn most cases, unsuitable benzodiazepines with slow absorption due to oral administration were prescribed, or buccal midazolam solution was used off-label in adults. Furthermore, inappropriate use of emergency medication at every seizure was reported by a substantial number of participating patients.
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