A new study shows that paramedics can safely and effectively treat patients who are suffering from acute and prolonged seizures with injections of benzodiazepines, a mild form of tranquilizers.
In 59 percent of patients who received lorazepam, and in 43 percent of patients treated with diazepam, the seizures stopped before they arrived at the emergency department. Conversely, only 21 percent of patients in the placebo group arrived at the hospital seizure free.
The study is reported in the August 30, 2001 issue of The New England Journal of Medicine* by Daniel H. Lowenstein, M.D., now at Harvard Medical School in Boston, and formerly with the University of California at San Francisco, where the study took place. The lead author is Brian Alldredge, PharmD, UCSF professor of clinical pharmacy and clinical professor of neurology. The National Institute of Neurological Disorders and Stroke (NINDS) funded the research.
The study included 205 patients diagnosed with "status epilepticus," continuous or repeated seizures lasting 5 minutes or more without recovery of consciousness. Benzodiazepines are the drugs of choice for initial control of the prolonged type of seizures once the patients are in the hospital, but until now there has been no research evaluating the drugs safety when they are delivered outside of the hospital.
The NEJM study reports that the odds that the patients seizure would terminate by the time of admission to an emergency department were 4.8 times higher in the lorazepam group compared to the placebo group; 2.3 times higher in the diazepam group versus the placebo group; and 1.9 times higher in the lorazepam group compared to the diazepam group.
Patients who received lorazepam also experienced shorter seizures than did the patients receiving diazepam or placebo.
The researchers also closely monitored respiratory and cardiovascular complications, which are common side effects of benzodiazepines. They reported com
Contact: Margo Warren
NIH/National Institute of Neurological Disorders and Stroke