{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T12:15:31Z","timestamp":1778933731132,"version":"3.51.4"},"reference-count":18,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T00:00:00Z","timestamp":1772755200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T00:00:00Z","timestamp":1772755200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Seizures, when prolonged or repeated, leading to status epilepticus (SE), represent a medical emergency, requiring prompt treatment. In these conditions, the use of continuous midazolam (MDZ) infusion is often reserved for established or refractory SE and considered an anesthesiologic treatment, while evidence on its early use in non\u2010intensive settings is still limited. To verify this approach in daily practice, we retrospectively collected data on about 42 episodes of pediatric SE or acute repetitive seizures (ARSs), treated with continuous MDZ infusion in non\u2010intensive setting. Collected data include demographical information, previous history of epilepsy, instrumental examinations (electroencephalography [EEG] and brain magnetic resonance imaging [MRI]), comorbidities, anti\u2010seizure medications (ASMs), information about the event, other treatments (first\u2010 and second\u2010line), information about MDZ infusion, and need for other third\u2010line treatment and\/or intensive care unit (ICU) transfer. Infusion durations and rates varied widely, but in most cases (38\/42) low dose (&lt;.23\u2009mg\/kg\/h) were employed. The treatment was effective in 84.2% of cases, achieving both clinical and EEG response. No adverse events (AEs) were reported. The need for a second\u2010line treatment (particularly levetiracetam [LEV] and phenobarbital [PB]) was associated with a worse outcome. Another third\u2010line treatment was needed in 9.5% of cases. Patients (21.4%) were transferred to ICU; a higher risk of ICU admission was reported in patients with precipitating factors (infection, surgery, hypertension and suboptimal anti\u2010seizure medication [ASM] serum levels), and those receiving MDZ infusion at higher rates and\/or co\u2010treated with PB. Overall, our study suggests that low\u2010dose continuous MDZ infusion is an effective and safe strategy for treatment of pediatric SE and ARSs in non\u2010intensive settings.<\/jats:p>","DOI":"10.1002\/epi.70180","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T03:32:16Z","timestamp":1773027136000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and safety of continuous midazolam infusion in the treatment of acute repetitive seizures in non\u2010intensive settings: A multicenter retrospective real\u2010world data study"],"prefix":"10.1002","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5256-6573","authenticated-orcid":false,"given":"Alessandro","family":"Orsini","sequence":"first","affiliation":[{"name":"Pediatric Neurology Azienda Ospedaliero\u2010Universitaria Pisana  Pisa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1142-5656","authenticated-orcid":false,"given":"Lorenza","family":"Marini","sequence":"additional","affiliation":[{"name":"Pediatric Neurology Azienda Ospedaliero\u2010Universitaria Pisana  Pisa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8214-1816","authenticated-orcid":false,"given":"Luca","family":"Bergonzini","sequence":"additional","affiliation":[{"name":"IRCCS Istituto delle Scienze Neurologiche di Bologna U.O.C. Neuropsichiatria dell'et\u00e0 pediatrica, Full Member of the ERN EpiCare  Bologna Italy"},{"name":"Department of Medical and Surgical Sciences (DIMEC) Alma Mater Studiorum \u2013 University of Bologna  Bologna Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"D'Angelo","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine University of Pisa  Pisa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia","family":"Lelli","sequence":"additional","affiliation":[{"name":"IRCCS Istituto delle Scienze Neurologiche di Bologna U.O.C. Neuropsichiatria dell'et\u00e0 pediatrica, Full Member of the ERN EpiCare  Bologna Italy"},{"name":"Department of Medical and Surgical Sciences (DIMEC) Alma Mater Studiorum \u2013 University of Bologna  Bologna Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0961-428X","authenticated-orcid":false,"given":"Thomas","family":"Foiadelli","sequence":"additional","affiliation":[{"name":"Clinica Pediatrica IRCCS Fondazione Policlinico San Matteo  Pavia Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eugenia","family":"Spreafico","sequence":"additional","affiliation":[{"name":"U.O.C. Pediatria, Ospedale Sant'Anna  Como Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1726-2124","authenticated-orcid":false,"given":"Viola","family":"Santi","sequence":"additional","affiliation":[{"name":"Pediatric Unit Azienda USL Toscana Nord\u2010Ovest  Cecina Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisabetta","family":"Mencaroni","sequence":"additional","affiliation":[{"name":"Clinica Pediatrica Azienda Ospedaliera \u2013 Universit\u00e0 degli Studi di Perugia  Perugia Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2403-1990","authenticated-orcid":false,"given":"Alberto","family":"Verrotti","sequence":"additional","affiliation":[{"name":"Clinica Pediatrica Azienda Ospedaliera \u2013 Universit\u00e0 degli Studi di Perugia  Perugia Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3854-9299","authenticated-orcid":false,"given":"Alessandro","family":"Ferretti","sequence":"additional","affiliation":[{"name":"Child Neurology, NESMOS Department, Faculty of Medicine and Psychology Sapienza University  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9042-8120","authenticated-orcid":false,"given":"Pasquale","family":"Parisi","sequence":"additional","affiliation":[{"name":"Child Neurology, NESMOS Department, Faculty of Medicine and Psychology Sapienza University  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7783-0262","authenticated-orcid":false,"given":"Riccardo","family":"Morganti","sequence":"additional","affiliation":[{"name":"Section of Statistics Pisa University Hospital  Pisa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brita","family":"De Lorenzo","sequence":"additional","affiliation":[{"name":"U.O. Anestesia e Rianimazione Materno\u2010Infantile S. Chiara Pisa University Hospital  Pisa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1737-5146","authenticated-orcid":false,"given":"Beate","family":"K\u00fcppers","sequence":"additional","affiliation":[{"name":"U.O. Anestesia e Rianimazione Materno\u2010Infantile S. Chiara Pisa University Hospital  Pisa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7457-2779","authenticated-orcid":false,"given":"Alice","family":"Bonuccelli","sequence":"additional","affiliation":[{"name":"Pediatric Neurology Azienda Ospedaliero\u2010Universitaria Pisana  Pisa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7889-1355","authenticated-orcid":false,"given":"Roberta","family":"Battini","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine University of Pisa  Pisa Italy"},{"name":"Department of Neuroscience IRCCS Stella Maris Foundation  Pisa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0234-1373","authenticated-orcid":false,"given":"Diego","family":"Peroni","sequence":"additional","affiliation":[{"name":"Pediatric Neurology Azienda Ospedaliero\u2010Universitaria Pisana  Pisa Italy"},{"name":"Department of Clinical and Experimental Medicine University of Pisa  Pisa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1367-6419","authenticated-orcid":false,"given":"Duccio Maria","family":"Cordelli","sequence":"additional","affiliation":[{"name":"IRCCS Istituto delle Scienze Neurologiche di Bologna U.O.C. 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