{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T16:10:36Z","timestamp":1788970236013,"version":"build-2803163510"},"reference-count":13,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"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"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Acute seizure crises, such as prolonged seizures and impending status epilepticus, need prompt out\u2010of\u2010hospital treatment with benzodiazepines. However, efficacious and easily administered rescue medications are grossly underutilized and form an unmet need in management paradigms. The aim of the current study was to compare the efficacy of mouth\u2010dissolving clobazam with intranasal midazolam in terminating seizures in the epilepsy monitoring unit (EMU).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A single\u2010center, prospective, randomized, open blinded end point (PROBE) trial was conducted over a period of 1.5\u2009years. Patients with drug\u2010resistant epilepsy (DRE) having clobazam as one of the polytherapy agents were enrolled prospectively into the study. They were randomized to receive either intranasal midazolam or mouth\u2010dissolving clobazam if they had prolonged seizures lasting more than 2\u2009min. Time to clinical and electrographic termination of seizures was the primary outcome. Adverse effects or injury, treatment failure, seizure recurrence, and treatment satisfaction were secondary outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Ninety\u2010five patients were enrolled in the study: 47 in the intranasal midazolam group, and 48 in mouth dissolving clobazam group. The Cox proportional hazards model suggested hazard ratio [HR]: .39 (.15\u20131.02) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.05), for clinical termination of seizures, and HR: .56 (.23\u20131.37) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.22), for electrographic termination of seizures. The log\u2010rank test suggested no statistically significant difference between two curves with respect to time of termination of clinical (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.17) and electrographic (\n                      <jats:italic>p<\/jats:italic>\n                      =\u2009.39) seizures.\n                    <\/jats:p>\n                    <jats:p>There were no significant adverse effects, and treatment failure or seizure recurrence was noted in either arm. Treatment satisfaction did not significantly differ between the two arms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>There was no statistically significant difference between intranasal midazolam and mouth\u2010dissolving clobazam for termination of clinical and electrographic seizures. We propose that mouth\u2010dissolving clobazam merits further research as a reasonably efficacious, convenient, and cost\u2010effective alternative to intranasal midazolam for acute termination of pre\u2010hospital seizures.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epi.70475","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T15:22:40Z","timestamp":1788967360000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Intranasal midazolam vs mouth\u2010dissolving clobazam in terminating seizures: A randomized controlled trial"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5819-1143","authenticated-orcid":false,"given":"Saman","family":"Fatima","sequence":"first","affiliation":[{"name":"Department of Neurology Govind Ballabh Pant Institute of Medical Education and Research  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0128-7037","authenticated-orcid":false,"given":"Arunmozhimaran","family":"Elavarasi","sequence":"additional","affiliation":[{"name":"Department of Neurology All India Institute of Medical Sciences  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9900-9579","authenticated-orcid":false,"given":"Bhargavi","family":"Ramanujam","sequence":"additional","affiliation":[{"name":"Department of Neurology All India Institute of Medical Sciences  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1969-9603","authenticated-orcid":false,"given":"Rajesh Kumar","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Neurology All India Institute of Medical Sciences  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3659-7526","authenticated-orcid":false,"given":"Deepti","family":"Vibha","sequence":"additional","affiliation":[{"name":"Department of Neurology All India Institute of Medical Sciences  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3587-0968","authenticated-orcid":false,"given":"S. C.","family":"Sarangi","sequence":"additional","affiliation":[{"name":"Department of Pharmacology All India Institute of Medical Sciences  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9449-6518","authenticated-orcid":false,"given":"M. A.","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Biostatistics All India Institute of Medical Sciences  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7339-108X","authenticated-orcid":false,"given":"Shashank","family":"Tripathi","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Medical Informatics University College of Medical Sciences  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8775-7767","authenticated-orcid":false,"given":"Manjari","family":"Tripathi","sequence":"additional","affiliation":[{"name":"Department of Neurology All India Institute of Medical Sciences  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"crossref","unstructured":"EnglandTN.A 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epileptic seizures","volume":"27","author":"Tinuper P","year":"1986","journal-title":"Epilepsia"},{"key":"e_1_2_14_10_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.eplepsyres.2022.107037","article-title":"The IN\u2010MIDAZ study \u2013 intranasal midazolam in aborting seizures \u2013 an epilepsy monitoring unit based randomized controlled trial for efficacy","volume":"188","author":"Gulfam R","year":"2022","journal-title":"Epilepsy Res"},{"key":"e_1_2_14_11_1","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1111\/ane.13183","article-title":"Seizure recurrence risk in persons with epilepsy undergoing antiepileptic drug tapering","volume":"141","author":"Kumar S","year":"2019","journal-title":"Acta Neurol Scand"},{"key":"e_1_2_14_12_1","unstructured":"NICE.Epilepsies in children young people and 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