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Buccal midazolam may be a useful alternative to rectal diazepam for treating acute seizures in refractory epilepsy

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 QUESTION: In children and adolescents with refractory epilepsy, is buccal midazolam in solution as effective and safe as rectal diazepam in solution for treating acute seizures?


Randomised (allocation concealed*), unblinded,* controlled trial with follow-up to end of seizure.


A residential centre for children and young people with severe epilepsy and other needs in Lingfield, Surrey, UK.


18 of 42 enrolled students with refractory epilepsy (mean age 15 y, 50% girls) who had previously received rectal diazepam for acute seizures and who had a seizure that lasted ≥3 minutes during the study period. Follow-up was complete.


When a seizure occurred, the student …

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  • For correspondence: Dr R C Scott, Wolfson Centre, Mecklenburgh Square, London WC1N 2AP, UK. FAX +44-(0)171-833-9469.

  • * See glossary.