{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T04:37:34Z","timestamp":1784263054790,"version":"3.55.0"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Seizures are very common in children. They frequently happen in outpatient settings, in the presence of caregivers who are not always trained in their management. First-line rescue therapy is based on benzodiazepine, historically diazepam. Recent studies have investigated the use of other benzodiazepines in the treatment of acute seizures.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Objectives<\/jats:title>\n            <jats:p>The aims of this study were to evaluate the management of pediatric seizures carried out by parents or caregivers in an outpatient setting and to evaluate the differences in terms of immediate management and subsequent outcome when comparing the use of rectal diazepam versus buccal midazolam.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>In this retrospective study, medical records of children consulting for seizures at the Robert Debr\u00e9 Pediatric Emergency Department of Paris, France, over 18 months were analyzed to evaluate seizure characteristics, management by caregivers, received treatments, and the admission rate.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Five hundred ninety-four patients resulted eligible for the study. The interview was completed for 135 children who presented a further episode of seizure after inclusion. In the subgroup of children receiving buccal midazolam, compared with the subgroup receiving intrarectal diazepam, seizure duration was significantly shorter (10.3 vs 48.4 minutes, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.0004), and the risk of a status epilepticus decreased (1 vs 11, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.0008). The admission rate was not different between the 2 subgroups.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Based on our results, buccal midazolam seems to have some advantages compared with rectal diazepam in terms of feasibility in an outpatient setting and in terms of reduced seizure duration.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/pec.0000000000001114","type":"journal-article","created":{"date-parts":[[2017,3,28]],"date-time":"2017-03-28T20:12:22Z","timestamp":1490731942000},"page":"760-764","source":"Crossref","is-referenced-by-count":9,"title":["Buccal Midazolam Compared With Rectal Diazepam Reduces Seizure Duration in Children in the Outpatient Setting"],"prefix":"10.1097","volume":"35","author":[{"given":"Raffaella","family":"Moretti","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastien","family":"Julliand","sequence":"additional","affiliation":[{"name":"Pre-Hospital Care Unit, SMUR P\u00e9diatrique, Robert Debre Hospital, Paris, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria Elisa","family":"Rinaldi","sequence":"additional","affiliation":[{"name":"Pediatric Emergency Department"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Titomanlio","sequence":"additional","affiliation":[{"name":"Pediatric Emergency Department"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2017,3,27]]},"reference":[{"key":"bib1-20231002","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1016\/j.eplepsyres.2015.04.002","article-title":"The incidence of unprovoked seizures and occurrence of neurodevelopmental comorbidities in children at the time of their first epileptic seizure and during the subsequent six months","volume":"113","year":"2015","journal-title":"Epilepsy Res"},{"key":"bib2-20231002","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1542\/peds.2010-3318","article-title":"Neurodiagnostic evaluation of the child with a simple febrile seizure","volume":"127","year":"2011","journal-title":"Pediatrics"},{"key":"bib3-20231002","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1111\/j.1553-2712.2001.tb00175.x","article-title":"Emergency department management of patients with seizures: a multicenter study","volume":"8","year":"2001","journal-title":"Acad Emerg Med"},{"key":"bib4-20231002","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/S0006-8993(98)01080-4","article-title":"Time-dependent decrease in the effectiveness of antiepileptic drugs during the course of self-sustaining status epilepticus","volume":"814","year":"1998","journal-title":"Brain Res"},{"issue":"suppl 3","key":"bib5-20231002","first-page":"106","article-title":"Glutamate and GABA in the balance: convergent pathways sustain seizures during status epilepticus","volume":"51","year":"2010","journal-title":"Epilepsia"},{"key":"bib6-20231002","first-page":"CD001905","article-title":"Drug management for acute tonic-clonic convulsions including convulsive status epilepticus in children","year":"2008","journal-title":"Cochrane Database Syst Rev"},{"key":"bib7-20231002","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1111\/j.1469-8749.1995.tb15014.x","article-title":"Lorazepam versus diazepam in the acute treatment of epileptic seizures and status epilepticus","volume":"37","year":"1995","journal-title":"Dev Med Child Neurol"},{"key":"bib8-20231002","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1177\/000992280504400904","article-title":"A comparison of buccal midazolam and rectal diazepam for the acute treatment of seizures","volume":"44","year":"2005","journal-title":"Clin Pediatr"},{"key":"bib9-20231002","first-page":"398","article-title":"Buccal midazolam and rectal diazepam for treatment of prolonged seizures in childhood and adolescence: a randomised trial","volume":"135","year":"1999","journal-title":"J Pediatr"},{"key":"bib10-20231002","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1016\/S0140-6736(98)06425-3","article-title":"Buccal midazolam and rectal diazepam for treatment of prolonged seizures in childhood and adolescence: a randomised trial","volume":"353","year":"1999","journal-title":"Lancet"},{"key":"bib11-20231002","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/S0140-6736(05)66909-7","article-title":"Safety and efficacy of buccal midazolam versus rectal diazepam for emergency treatment of seizures in children: a randomised controlled trial","volume":"366","year":"2005","journal-title":"Lancet"},{"key":"bib12-20231002","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1111\/j.1553-2712.2010.00751.x","article-title":"Midazolam versus diazepam for the treatment of status epilepticus in children and young adults: a meta-analysis","volume":"17","year":"2010","journal-title":"Acad Emerg Med"},{"key":"bib13-20231002","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1007\/s13341-013-0316-z","article-title":"Prise en charge par les parents des convulsions de l\u2019enfant au domicile. Parental management of children\u2019s seizures at home","volume":"3","year":"2013","journal-title":"Ann Fr Med Urgence"},{"key":"bib14-20231002","first-page":"260","article-title":"Treatment of generalized convulsive status epilepticus in pediatric patients","volume":"20","year":"2015","journal-title":"J Pediatr Pharmacol Ther"},{"key":"bib15-20231002","first-page":"481","article-title":"Cost-effectiveness of buccal midazolam in the treatment of prolonged convulsive seizures in the outpatient setting in Spain [in Spanish]","volume":"58","year":"2014","journal-title":"Rev Neurol"},{"key":"bib16-20231002","doi-asserted-by":"crossref","first-page":"e165","DOI":"10.1111\/apa.12529","article-title":"Carers\u2019 express positive views on the acceptability, efficacy and safety of buccal midazolam for paediatric status epilepticus","volume":"103","year":"2014","journal-title":"Acta Paediatr"},{"key":"bib17-20231002","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1136\/archdischild-2015-308857","article-title":"Recovery position significantly associated with a reduced admission rate of children with loss of consciousness","volume":"101","year":"2016","journal-title":"Arch Dis Child"},{"issue":"suppl 7","key":"bib18-20231002","first-page":"23","article-title":"Treatment of convulsive status epilepticus in childhood: recommendations of the Italian League Against Epilepsy","volume":"54","year":"2013","journal-title":"Epilepsia"},{"key":"bib19-20231002","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1016\/j.eplepsyres.2012.07.018","article-title":"Bioavailability of intranasal vs. rectal diazepam","volume":"103","year":"2013","journal-title":"Epilepsy Res"}],"container-title":["Pediatric Emergency Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/PEC.0000000000001114","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T15:06:12Z","timestamp":1696259172000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/PEC.0000000000001114"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,3,27]]},"references-count":19,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2019]]}},"URL":"https:\/\/doi.org\/10.1097\/pec.0000000000001114","relation":{},"ISSN":["1535-1815","0749-5161"],"issn-type":[{"value":"1535-1815","type":"electronic"},{"value":"0749-5161","type":"print"}],"subject":[],"published":{"date-parts":[[2017,3,27]]}}}