Intranasal midazolam for febrile seizuresBMJ 2000; 321 doi: https://doi.org/10.1136/bmj.321.7253.64i:10.1136/bmj.321.7253.64 (Published 08 July 2000) Cite this as: BMJ 2000;321:64
A step forward in treating a common and distressing condition
- Gideon Koren, professor
- Hospital for Sick Children, 555 University Avenue, Toronto, ON, Canada M5G 1XS
Papers p 83
Despite their benign nature and prognosis, uncomplicated febrile seizures are extremely stressful for both families and medical staff. Most parents believe that these seizures are harmful, and during the first episode half of all parents fear that their child is dying.1 For decades children were given long term anticonvulsant drugs to prevent the recurrence of febrile seizures. Although some of these are effective, their serious adverse effects have led to an unacceptable ratio of benefits to risks.2 3
There is, however, a broad consensus that febrile seizures should be treated promptly. Traditionally, benzodiazepines, barbiturates, or other anticonvulsants have been given intravenously, but rectally administered diazepam is now used as an efficacious alternative.
The intranasal administration of therapeutic agents is undoubtedly the centre of tremendous interest in the field of therapeutics. That there is extensive and prompt absorption of molecules through the nasal mucosa into a rich vascular bed has long been recognised by cocaine users.