ArticleChildren (Basel, Switzerland)2025
Early Midazolam Infusion in Pediatric Status Epilepticus: Defining an Early Therapeutic Window for Seizure Control.
Article in Children (Basel, Switzerland), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundStatus epilepticus (SE) is a neurological emergency with high morbidity and mortality in childhood, where rapid and effective intervention is essential to prevent neuronal injury. Experimental studies suggest that time-dependent loss of GABAergic responsiveness creates an early therapeutic window during which benzodiazepines are most effective for acute seizure suppression.
methodsThis retrospective study analyzed 63 pediatric patients (mean age 46.5 ± 4.9 months) with first-episode SE treated between 2008 and 2022. Patients were categorized according to the timing of continuous midazolam infusion as early (≤15 min from seizure onset) or late (>15 min). Primary outcome was time to seizure control; secondary outcomes included infusion duration and epilepsy development during two-year follow-up.
resultsEarly infusion significantly shortened time to seizure control (21.8 ± 1.5 min vs. 29.3 ± 2.8 min,
conclusionsInitiating continuous midazolam infusion within 15 min of seizure onset defines a clinically relevant early therapeutic window for pediatric SE. While infusion timing did not significantly alter long-term epileptogenesis, early initiation was associated with improved acute seizure control and shorter treatment duration, underscoring the importance of time-sensitive intervention in pediatric neuroemergencies.
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