{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T14:42:40Z","timestamp":1785336160342,"version":"3.55.0"},"reference-count":25,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,28]],"date-time":"2025-12-28T00:00:00Z","timestamp":1766880000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: Status epilepticus (SE) is a neurological emergency with high morbidity and mortality in childhood, where rapid and effective intervention is essential to prevent neuronal injury. Experimental studies suggest that time-dependent loss of GABAergic responsiveness creates an early therapeutic window during which benzodiazepines are most effective for acute seizure suppression. Methods: This retrospective study analyzed 63 pediatric patients (mean age 46.5 \u00b1 4.9 months) with first-episode SE treated between 2008 and 2022. Patients were categorized according to the timing of continuous midazolam infusion as early (\u226415 min from seizure onset) or late (&gt;15 min). Primary outcome was time to seizure control; secondary outcomes included infusion duration and epilepsy development during two-year follow-up. Results: Early infusion significantly shortened time to seizure control (21.8 \u00b1 1.5 min vs. 29.3 \u00b1 2.8 min, p = 0.029) and reduced infusion duration (18.4 \u00b1 2.5 h vs. 32.7 \u00b1 7.5 h, p = 0.049) compared with later initiation. Epilepsy developed in 74.6% of patients over two years, with no significant difference between early and late infusion groups (p = 0.079). Conclusions: Initiating continuous midazolam infusion within 15 min of seizure onset defines a clinically relevant early therapeutic window for pediatric SE. While infusion timing did not significantly alter long-term epileptogenesis, early initiation was associated with improved acute seizure control and shorter treatment duration, underscoring the importance of time-sensitive intervention in pediatric neuroemergencies.<\/jats:p>","DOI":"10.3390\/children13010043","type":"journal-article","created":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T06:25:51Z","timestamp":1766989551000},"page":"43","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Early Midazolam Infusion in Pediatric Status Epilepticus: Defining an Early Therapeutic Window for Seizure Control"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8299-6926","authenticated-orcid":false,"given":"M\u00fcge","family":"Baykan","sequence":"first","affiliation":[{"name":"Department of Pediatric Neurology, Recep Tayyip Erdo\u011fan University Training and Research Hospital, Rize 53100, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y\u00fcksel","family":"B\u0131c\u0131l\u0131o\u011flu","sequence":"additional","affiliation":[{"name":"Department of Pediatric Emergency Medicine, Faculty of Medicine, Izmir Katip \u00c7elebi University, Izmir 35460, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alper","family":"\u00c7i\u00e7ek","sequence":"additional","affiliation":[{"name":"Department of Pediatric Emergency Medicine, Faculty of Medicine, \u0130zmir Tepecik Education and Research Hospital, Izmir 35460, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Murat","family":"Duman","sequence":"additional","affiliation":[{"name":"Department of Pediatric Emergency Medicine, Faculty of Medicine, Dokuz Eyl\u00fcl University, Izmir 35390, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emel","family":"Ulusoy","sequence":"additional","affiliation":[{"name":"Department of Pediatric Emergency Medicine, Faculty of Medicine, Dokuz Eyl\u00fcl University, Izmir 35390, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5902-3501","authenticated-orcid":false,"given":"Nihal","family":"Olga\u00e7 D\u00fcndar","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neurology, Faculty of Medicine, Izmir Katip \u00c7elebi University, Izmir 35620, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3223-5408","authenticated-orcid":false,"given":"P\u0131nar","family":"Gen\u00e7p\u0131nar","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neurology, Faculty of Medicine, Izmir Katip \u00c7elebi University, Izmir 35620, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/S1474-4422(24)00430-7","article-title":"Diagnosis and management of status epilepticus: Improving the status quo","volume":"24","author":"Gettings","year":"2025","journal-title":"Lancet Neurol."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Calonge, Q., Hanin, A., Januel, E., Guinebretiere, O., Nedelec, T., Le Gac, F., Chavez, M., du Montcel, S.T., and Navarro, V. 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