Abstract: Twenty-eight children with tonic clonic seizures and with mean age
of 4.6 years received buccal midazolam in a dose of 0.2 mg/kg for control of
seizures. Thirteen children were known epilepsy and were on regular
antiepileptic treatment, eight had febrile seizures, four had idiopathic first
onset seizures, two had meningitis and one hypocalcemia. The seizures were
controlled in 64% midazolam and seven patients needed a second dose. These
seven patients also received phenytoin/phenobarbitone infusion following the
2nd dose of buccal midazolam. The dose of buccal
midazolam was not increased to more than 0.2 mg/kg in any of the patients. Low
dose midazolam given by the buccal route is often sufficient to control
seizures effectively.