Comparison of intravenous lidocaine and midazolam infusion for refractory convulsive status epilepticus in children

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