Affiliations: Department of Pediatrics, Shaheed Sadoughi University
of Medical Sciences and Health Services, Yazd, Iran | Department of Pediatric Neurology, Mofid Children's
Hospital, Shaheed Beheshti University of Medical Sciences and Health Services,
Tehran, Iran
Abstract: Twenty children including nine boys and eleven girls with a mean age
of 3.8 years (range: 0.1–12 years) and admitted with a diagnosis of refractory
convulsive status epilepticus constituted the study group. Ten children among
them were treated with intravenous lidocaine (group 1) and other ten received
midazolam infusion (group 2) for control of seizures. Variables such as age,
sex, neuroimaging, electroencephalographic findings, concomitant fever,
neurodevelopmental delay, complications, seizure control and length of stay
(days) in the intensive care unit were carefully recorded. Two out of ten
(20%) patients in group 1 responded while as five out of ten (50%)
patients in group 2 responded (P=0.1). No paraclinical side effects occurred
in any patients in both the groups. Two patients needed intubation in group 1
as against seven in group 2 (P=0.03). Mean length of stay
in the intensive care unit was 4.6 days in group 1 and 9.2 days in group 2
(P=0.04). No significant differences were seen with regard
to age, sex, electroencephalographic findings, neuroimaging abnormalities or
neurodevelopmental delay between the two groups. In conclusion, lidocaine can
be used in refractory status epilepticus treatment especially when respiratory
care and intubation facilities are not present.
Keywords: Status epilepticus, intravenous lidocaine, midazolam infusion
