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Journal of Child Neurology
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Successful Management of Refractory Neonatal Seizures With Midazolam

Deepa Sirsi, MD

Division of Pediatric Neurology, Department of Pediatrics, New York Presbyterian Hospital-Weill Cornell Medical College, New York

Srishti Nangia, MD

Division of Pediatric Neurology, Department of Pediatrics, New York Presbyterian Hospital-Weill Cornell Medical College, New York

Jacqueline LaMothe, MSN, CPNP, RN

Division of Pediatric Neurology, Department of Pediatrics, New York Presbyterian Hospital-Weill Cornell Medical College, New York, jal9012{at}nyp.org

Barry E. Kosofsky, MD, PhD

Division of Pediatric Neurology, Department of Pediatrics, New York Presbyterian Hospital-Weill Cornell Medical College, New York

Gail E. Solomon, MD

Division of Pediatric Neurology, Department of Pediatrics, New York Presbyterian Hospital-Weill Cornell Medical College, New York

Seizures are indicative of underlying neurologic dysfunction in neonates. Repeated seizures may be deleterious to the brain even without disturbances of ventilation or perfusion. First-line antiepileptic drugs such as phenobarbital and phenytoin are not very effective in controlling seizures in neonates. Rapid control of status epilepticus with midazolam has been demonstrated in 2 previous studies with complete clinical and electrographic response in neonates who did not respond to phenobarbital and phenytoin. We report our experience with 3 neonates with status epilepticus. Seizures in all 3 neonates did not respond to phenobarbital and phenytoin but responded to midazolam infusion. Midazolam may be considered a safe and effective antiepileptic drug in refractory neonatal seizures of diverse etiologies.

Key Words: neonatal seizures • midazolam

Journal of Child Neurology, Vol. 23, No. 6, 706-709 (2008)
DOI: 10.1177/0883073807313041
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H. C. Glass and E. Wirrell
Controversies in Neonatal Seizure Management
J Child Neurol, May 1, 2009; 24(5): 591 - 599.
[Abstract] [PDF]