The community use of rescue medication for prolonged epileptic seizures in children

Abstract

Objectives: The objectives for this study were to determine the prevalence of use, safety and efficacy of different preparations of rescue medication used for prolonged seizures in children in the community and to use the information gained to inform good practice within the network.

Methods: For all children in the EPIC area who had been prescribed epilepsy rescue medication for use in the community a questionnaire was completed by the clinician for each child relating to rescue medication prescribed, the epilepsy syndrome and seizure type. A questionnaire was also completed by the carers about their experience of the use of rescue medication in their child.

Results: A total of 203 paediatrician questionnaires were returned and 190 parent/carer questionnaires were returned. Buccal Midazolam was the most popular rescue medication (Buccal Midazolam 110, Rectal Diazepam 85, Paraldehyde 8). Over 80% of the children had a community care plan in place. 90% of carers recalled receiving instruction/training in the administration of rescue medication. The majority (73%) of carers perceived Buccal Midazolam and Rectal Diazepam to be effective in preventing hospital admission.

Conclusion: Buccal Midazolam in its propriety form is the rescue medication most commonly prescribed by EPIC epilepsy paediatricians. It was felt by families to be the safest (least side effects reported) and the most effective (most likely to terminate seizures) of the rescue medications. Children with severe epilepsy benefit from the use of rescue medications and the number of hospital admissions for prolonged seizures is reduced.