A Psychological and Physiological Evaluation of the Effects of Intravenous Diazepam

1973 ◽  
Vol 122 (569) ◽  
pp. 419-426 ◽  
Author(s):  
Desmond Kelly ◽  
Robert Pik ◽  
Char-nie Chen
Keyword(s):  
Status Epilepticus ◽  
Anaesthetic Agent ◽  
General Medicine ◽  
Muscle Spasm ◽  
Systematic Desensitization ◽  
Drug Induced ◽  
Psychiatric Emergencies ◽  
Intravenous Diazepam ◽  
Stiff Man Syndrome ◽  
Physiological Evaluation

Intravenous diazepam is widely used both in general medicine and in psychiatry. It is used to produce sedation in psychiatric emergencies and to enhance systematic desensitization; it is also employed in the treatment of drug-induced dystonic reactions, status epilepticus and tetanus, and as an anaesthetic agent. Its property of relieving severe muscle spasm has been utilized to treat patients suffering from ‘stiff-man syndrome‘.

Noncompliance Contributing to Apparent Drug Failure in Status Epilepticus

PEDIATRICS ◽  
1974 ◽  
Vol 53 (6) ◽  
pp. 938-940
Author(s):  
John T. Wilson
Keyword(s):  
Status Epilepticus ◽  
Plasma Levels ◽  
Seizure Activity ◽  
Drug Level ◽  
Continuous Control ◽  
Drug Plasma ◽  
Intravenous Diazepam ◽  
Grand Mal ◽  
History Of ◽  
Drug Plasma Levels

The case to be described illustrates apparent drug failure because of noncompliance in the drug delivery system, and the sequelae of this mishap. In connection with investigation of this case further occurrences of noncompliance were found. This incident also brings into focus the importance of plasma drug level determinations for effective application of therapy. CASE REPORT A 7-year-old, 26-kg, black girl was admitted with a 16-month history of nonprogressive neurologic disease accompanied by clinical and EEG evidence of petit mal and grand mal epilepsy which responded to diphenylhydantoin (DPH), phenobarbital or ethosuximide (Zarontin) treatment. Generalized convulsions had been infrequent for four months, but, before the present admission, a marked increase in grand mal seizures was noted. On the day of admission (day 1), recurrent generalized seizure activity progressed to status epilepticus within six hours. Intravenous diazepam (Valium [0.18/mg/kg]) controlled the seizures. Primidone (Mysoline), 250 mg tid, and ethosuximide, 500 mg tid were prescribed as maintenance anticonvulsants in an attempt to allay further progression to status epilepticus. For the next several days her seizures could be controlled only with paraldehyde (0.36 mg/kg intravenously), although administration of other drugs was continued. Assays of drug plasma levels did not become available until day 6. They disclosed that plasma levels of diazepam and demethyldiazepam were high (289 and 50 ng/ml, respectively) one hour after dosing with 0.18 mg/kg. This indicated that diazepam was not effective for continuous control of seizures, but this information was not acted upon immediately. The most striking finding was that primidone was not detected in plasma, although the prescibed dosage was 250 mg tid.

Nonconvulsive Status Epilepticus on Electroencephalography in a Case With Subacute Sclerosing Panencephalitis

2006 ◽  
Vol 21 (3) ◽  
pp. 256-260
Author(s):  
Ömer Faruk Aydin ◽  
Nesrin Şenbil ◽  
Y. K. Yavuz Gürer
Keyword(s):  
Status Epilepticus ◽  
Subacute Sclerosing Panencephalitis ◽  
Closed Head Injury ◽  
High Amplitude ◽  
Nonconvulsive Status Epilepticus ◽  
Computed Tomographic ◽  
Cognitive Difficulties ◽  
Intravenous Diazepam ◽  
Electroencephalogram Eeg ◽  
The Brain

Subacute sclerosing panencephalitis is a neurodegenerative disease with a poor prognosis. We report a case of a 5Z\x-year-old boy who had emotional lability, cognitive difficulties, and myoclonia after a mild closed head injury. The magnetic resonance image of the brain and computed tomographic scan of the head were normal. His electroencephalogram (EEG) showed continuous nonconvulsive status epilepticus activity, which could not be suppressed with intravenous diazepam. After treatment with phenytoin for 2 days, an EEG showed periodic high-amplitude sharp-and-slow-wave complexes, which were also not suppressed with intravenous diazepam. Since the patient had measles at 5 months of age, subacute sclerosing panencephalitis was considered, and the diagnosis was confirmed by the presence of measles antibodies in cerebrospinal fluid. ( J Child Neurol 2006;21:256—260; DOI 10.2310/7010.2006.00056).

Prehospital Administration of Rectal Diazepam in Pediatric Status Epilepticus

1990 ◽  
Vol 5 (2) ◽  
pp. 155-158
Author(s):  
Rodney E. Drawbaugh ◽  
Christopher G. Deibler ◽  
David R. Eitel
Keyword(s):  
Status Epilepticus ◽  
Seizure Activity ◽  
Neuronal Damage ◽  
Rectal Administration ◽  
The United States ◽  
Morbidity Rate ◽  
Drug Of Choice ◽  
Rectal Diazepam ◽  
Intravenous Diazepam ◽  
Alternate Routes

Seizures are a common pediatric problem encountered by prehospital personnel. Status epilepticus is defined as seizure activity lasting longer than 15 minutes, or recurrent seizures that occur close together without a period of consciousness between ictal periods. It is estimated that 60,000 to 160,000 cases of status epilepticus occur each year within the United States. Prior to 1960, status epilepticus carried a 50% morbidity rate. However, improved anticonvulsive medications, aggressive airway management, and the spread of EMS Systems throughout the nation have reduced the morbidity rate to a range of 8% to 12%.Prompt and vigorous treatment is paramount in the successful management of status epilepticus because delays can result in neuronal damage and death. Although intravenous diazepam currently is the drug of choice to terminate seizure activity, it may be difficult to rapidly establish a patent intravenous (IV) line during status epilepticus in young children with vigorous motor activity. Alternate routes, such as intramuscular injections, are unreliable due to unpredictable absorption. Rectal administration of diazepam may provide an useful alternate route for delivery of the drug during status epilepticus when IV attempts fail.In this review, the authors discuss a case of status epilepticus wherein intravenous access could not be established rapidly and the patient was given diazepam rectally with favorable results.

Status Epilepticus after Electroconvulsive Therapy

1989 ◽  
Vol 155 (1) ◽  
pp. 119-121 ◽  
Author(s):  
Allan I. F. Scott ◽  
William Riddle
Keyword(s):  
Status Epilepticus ◽  
Electroconvulsive Therapy ◽  
Rare Complication ◽  
Eeg Monitoring ◽  
Prolonged Seizure ◽  
Intravenous Diazepam ◽  
The Status ◽  
Motor Movements

Status epilepticus is a rare complication of ECT. We describe a patient who suffered a prolonged seizure which required termination with intravenous diazepam. The status epilepticus was not accompanied by motor movements, and the diagnosis was made only because of simultaneous EEG monitoring. The incidence of status epilepticus after ECT may be underestimated.

Intravenous Diazepam in Drug-Induced Dystonic Reactions

1972 ◽  
Vol 121 (1) ◽  
pp. 75-77 ◽  
Author(s):  
A. D. KORCZYN ◽  
G. J. GOLDBERG
Keyword(s):  
Drug Induced ◽  
Intravenous Diazepam

scholarly journals Characteristics of Patient with Status Epilepticus at the Emergency Department of Sanglah General Hospital

2021 ◽  
Vol 8 (12) ◽  
pp. 211-217
Author(s):  
Maria Oktaviany Gabur ◽  
I Wayan Widyantara ◽  
Anna M.G. Sinardja
Keyword(s):  
Status Epilepticus ◽  
General Hospital ◽  
Medical Records ◽  
Seizure Activity ◽  
Initial Therapy ◽  
Platelet Volume ◽  
Seizure Duration ◽  
Neutrophil Lymphocyte Ratio ◽  
Intravenous Diazepam ◽  
Patient’S Outcome

Introduction: Status epilepticus is a neurological condition caused by a failure of body mechanism to terminate the seizures or the onset of abnormal seizure activity resulting in prolonged seizure’s duration for more than five minutes. The available research data on status epilepticus in Indonesia is still limited. The purpose of this study was to determine the profile of patients with status epilepticus at Sanglah General Hospital from 2020 to 2021. Methods: This was a descriptive study with a retrospective approach. The study populations were patients with status epilepticus who were treated at Sanglah General Hospital in 2019-2020 who had no missing data in the medical records. Results: There were 117 patients with status epilepticus, 63 males (53.8%) and 54 females (46.2%). There are 41 patients>60 years (35%), general onset in 63 patients (53.8%), and focal onset in 54 patients (46.2%). Etiology from cerebral was 68 patients (58.1%), followed by metabolic in 28 patients (23.9%). The most common OAE therapy was phenytoin (86.3%) and the longest length of stay status epilepticus patients was 8 days (55.6%). Patients with status epilepticus had leukocytosis (73.5%), increased NLR (66.7%), and decreased mean platelet volume (53.8%). Conclusion: The highest incidence of status epilepticus is in women, above 60 years, general onset type of seizure, and etiology from cerebral. Initial therapy in 117 patients was intravenous diazepam followed by phenytoin for maintenance. NLR increased in most of the patients showing signs of inflammation which further worsened the patient's outcome with a mortality rate of 47%. Keywords: Status epilepticus, seizure duration, anticonvulsant, neutrophil-lymphocyte ratio.

scholarly journals Reactive astrocyte-driven epileptogenesis is induced by microglia initially activated following status epilepticus

2019 ◽  
Author(s):  
Fumikazu Sano ◽  
Eiji Shigetomi ◽  
Youichi Shinozaki ◽  
Haruka Tsuzukiyama ◽  
Kozo Saito ◽  
...  
Keyword(s):  
Status Epilepticus ◽  
Glial Cells ◽  
Reactive Astrocytes ◽  
Pharmacological Intervention ◽  
Seizure Susceptibility ◽  
Drug Induced ◽  
Reactive Microglia ◽  
Sequential Activation ◽  
Animal Models Of Epilepsy ◽  
Increased Susceptibility

AbstractExtensive activation of glial cells during a latent period has been well documented in various animal models of epilepsy; however, it remains unknown whether such glial activation is capable of promoting epileptogenesis. Here, we show that temporally distinct activation profiles of microglia and astrocytes collaboratively contribute to epileptogenesis in a drug-induced status epilepticus model. We found that reactive microglia appear first, followed by reactive astrocytes and increased susceptibility to seizures. Pharmacological intervention against microglial activation reduces astrogliosis, aberrant astrocyte Ca2+ signaling, and seizure susceptibility. Reactive astrocytes exhibit larger Ca2+ signals mediated by IP3R2, whereas deletion of this type of Ca2+ signaling reduces seizure susceptibility after status epilepticus. Together, our findings indicate that the sequential activation of glial cells constitutes a cause of epileptogenesis after status epilepticus.

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