Pediatric Neurology
Volume 33, Issue 3 , Pages 166-172, September 2005

Rectal Diazepam Gel in the Home Management of Seizures in Children

Presented in part at the American Epilepsy Society Annual Meetings, Los Angeles, California, December 1–6, 2000 and Boston, Massachusetts, December 5–10, 2003; and at Child Neurology Society Meeting, Ottawa, Canada, October 13–16, 2004.

  • Christine O’Dell, RN, MSN

      Affiliations

    • Department of Neurology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
    • Department of Nursing, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
    • Department of Comprehensive Epilepsy Management Center, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
    • Corresponding Author InformationCommunications should be addressed to: Ms. O’Dell; Clinical Nurse Specialist, Epilepsy; Comprehensive Epilepsy Management Center; Montefiore Medical Center; 111 East 210th Street; Bronx, New York 10467.
  • ,
  • Shlomo Shinnar, MD, PhD

      Affiliations

    • Department of Neurology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
    • Department of Comprehensive Epilepsy Management Center, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
    • Department of Pediatrics, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
  • ,
  • Karen R. Ballaban-Gil, MD

      Affiliations

    • Department of Neurology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
    • Department of Comprehensive Epilepsy Management Center, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
    • Department of Pediatrics, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
  • ,
  • Matthew Hornick

      Affiliations

    • Department of Neurology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
  • ,
  • Maryana Sigalova, MA

      Affiliations

    • Department of Neurology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
  • ,
  • Harriet Kang, MD

      Affiliations

    • Department of Neurology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
    • Department of Comprehensive Epilepsy Management Center, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
    • Department of Pediatrics, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
  • ,
  • Solomon L. Moshé, MD

      Affiliations

    • Department of Neurology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
    • Department of Comprehensive Epilepsy Management Center, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
    • Department of Pediatrics, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
    • Department of Neuroscience, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York

Received 16 December 2004; accepted 14 March 2005.

This study assessed the utility of rectal diazepam gel in the home management of prolonged or repetitive seizures in children. Thirty-eight children being prescribed rectal diazepam gel by their clinician were prospectively recruited. Seizures, rectal diazepam use, emergency department visits, and quality of life data before and after study entry were recorded. The 38 children included 14 (37%) with complex febrile seizures, and 24 with epilepsy (n = 22) or a single seizure (n = 2). There were 23 (61%) children with prolonged seizures and 15 (39%) with repetitive seizures. During the 6-month follow-up period, 12 children experienced 26 seizures which met the criteria for rectal diazepam administration. Rectal diazepam gel was administered to 8 children on 19 occasions. In 16 (84%) of these episodes, seizures stopped and no emergency department visit was required. Parental stress was decreased between baseline and 6 months in both the overall group and in all the subgroups. Home use of rectal diazepam gel is effective in aborting seizure activity, often avoiding an emergency department visit. Its use reduces morbidity and costs associated with hospital visits and provides parents a treatment option for home management of prolonged or repetitive seizures.

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PII: S0887-8994(05)00167-0

doi:10.1016/j.pediatrneurol.2005.03.005

Pediatric Neurology
Volume 33, Issue 3 , Pages 166-172, September 2005