Evidence map›Paper›PMID 39607396›Full record

ArticleEpilepsia2025

Benzodiazepine rescue medication administration for seizure clusters: Real-world retrospective outcomes.

Sharon Chiang, Robert Moss, Sunita N Misra, Enrique Carrazana, Adrian L Rabinowicz

Abstract read
In one paragraph

Article in Epilepsia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Sharon ChiangDepartment of Neurology and Weill Institute for Neurosciences, University of California, San Francisco, California, USA.ORCID 0000-0002-4548-4550
Robert MossSeizure Tracker LLC, Annandale, Virginia, USA.ORCID 0000-0002-9407-5681
Sunita N MisraSK Life Science, Inc., Paramus, New Jersey, USA.ORCID 0000-0002-7624-8825
Enrique CarrazanaNeurelis, Inc., San Diego, California, USA.ORCID 0000-0001-8788-0722
Adrian L RabinowiczNeurelis, Inc., San Diego, California, USA.ORCID 0000-0003-1299-0606

Funding

Neurelis
6 · The paper itself

Abstract

objectiveBenzodiazepine rescue medications are established as therapy for acute termination of seizure clusters. A post-hoc analysis of a clinical trial of seizure cluster treatment with diazepam nasal spray found a potential longer-term impact over a year of treatment. In this retrospective analysis, we tested the hypothesis that benzodiazepine-treated seizure clusters are associated with prolonged time to the next seizure cluster compared with untreated seizure clusters in a patient-reported real-world database.

methodsWe analyzed data on self-reported seizures and benzodiazepine rescue medication administration in the Seizure Tracker™ database between 2007 and 2022. Kaplan-Meier analysis was used to compare treated vs untreated seizure clusters with respect to time to start of the next seizure cluster or immediate-use medication administration. Mixed-effects analysis was used to compare the number of seizures per cluster for treated and untreated seizure clusters. Robustness of findings was evaluated across three operational seizure-cluster definitions: ≥2 seizures in 4 hours as primary analysis and in 6 and 24 hours as sensitivity analyses.

resultsA total of 10 889 benzodiazepine immediate-use medication administrations (n = 220 patients) met inclusion criteria. Benzodiazepine rescue administrations were followed by longer time to the next seizure cluster or rescue administration, compared with untreated seizure clusters, corresponding to a median of 4.9 days following treated seizure clusters and a median of 0.8 days following untreated seizure clusters. This prolongation was driven by a minority of patients (accounting for 45.9% of seizure clusters in the sample) and patients were more likely to be women. The number of seizures per cluster was lower when treatment was administered earlier in the seizure cluster. SIGNIFICANCE: These retrospective real-world data suggest that the effect of benzodiazepines on termination of seizure clusters may be more pronounced when administration occurs earlier after onset, and support a hypothesis of a possible longer-term effect of benzodiazepines beyond immediate-use acute seizure termination.

Indexed as

AnticonvulsantsBenzodiazepinesSeizuresAdolescentAdultAgedFemaleHumansMaleMiddle AgedRetrospective StudiesTreatment OutcomeYoung AdultAnticonvulsantsBenzodiazepinesacute repetitive seizuresbenzodiazepinesepilepsyrescue medicationsseizure clusters

Identifiers

PMID39607396
PMCPMC11827719

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Registered trials

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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.